School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
Gynaecological Research and Clinical Evaluation (GRACE) Unit, Royal Hospital for Women, Sydney, New South Wales, Australia.
Aust N Z J Obstet Gynaecol. 2021 Aug;61(4):585-590. doi: 10.1111/ajo.13355. Epub 2021 Apr 22.
In response to the COVID-19 pandemic in Australia, restrictions to elective surgeries were implemented nationwide.
To investigate the response to these restrictions in elective gynaecological and In vitro fertilisation (IVF) procedures during the first wave of the COVID-19 pandemic.
We analysed the Medicare Item Reports for the number of elective gynaecological (labioplasty, vulvoplasty; prolapse and continence; operative hysteroscopy; hysterectomy; fertility) and IVF procedures claimed in Australia between January-June 2020 and compared these to January-June 2019.
The number of included gynaecological and IVF procedures performed in January-June 2020 decreased by -13.71% and -12.56%, respectively, compared to January-June 2019. The greatest reductions were in May 2020 (gynaecology -43.71%; IVF -51.63% compared to May 2019), while April 2020 reported decreases of -37.69% and -31.42% in gynaecological and IVF procedures, respectively. In April 2020, 1963 IVF cycle initiations (-45.20% compared to April 2019), 2453 oocyte retrievals (-26.99%) and 3136 embryo transfers (-22.95%) were billed. The procedures with greatest paired monthly decrease were prolapse and continence surgeries in April (676 procedures; -51.85%) and May 2020 (704 procedures; -60.05%), and oocyte retrievals in May 2020 (1637 procedures; -56.70%).
While we observed a decrease in procedural volumes, elective gynaecological and IVF procedures continued in considerable numbers during the restricted timeframes. In the event of future overwhelming biological threat, careful consideration must be given to more effective measures of limiting access for non-emergency procedures to conserve essential resources and reduce risk to both the public and healthcare staff.
为应对澳大利亚的 COVID-19 大流行，全国范围内实施了选择性手术限制。
调查 COVID-19 大流行第一波期间对妇科和体外受精（IVF）手术限制的反应。
我们分析了 2020 年 1 月至 6 月期间在澳大利亚进行的选择性妇科（阴唇成形术、阴蒂成形术；脱垂和尿失禁；手术宫腔镜检查；子宫切除术；生育）和 IVF 手术的 Medicare 项目报告，并将其与 2019 年同期进行比较。
与 2019 年同期相比，2020 年 1 月至 6 月期间进行的妇科和 IVF 手术数量分别减少了 13.71%和 12.56%。最大的减少发生在 2020 年 5 月（妇科 -43.71%；IVF -51.63%与 2020 年 5 月相比），而 2020 年 4 月，妇科和 IVF 手术分别减少了 37.69%和 31.42%。2020 年 4 月，有 1963 个 IVF 周期启动（与 2020 年 4 月相比减少 45.20%）、2453 个卵母细胞回收（减少 26.99%）和 3136 个胚胎移植（减少 22.95%）。配对月减少幅度最大的手术是 2020 年 4 月和 5 月的脱垂和尿失禁手术（分别减少 676 例，减少 51.85%；676 例，减少 60.05%）和 2020 年 5 月的卵母细胞回收（减少 1637 例，减少 56.70%）。
虽然我们观察到手术量减少，但在限制时间内，选择性妇科和 IVF 手术仍在大量进行。在未来发生压倒性的生物威胁时，必须仔细考虑采取更有效的措施来限制非紧急手术的就诊次数，以节约宝贵资源并降低公众和医护人员的风险。
