Yorkshire and Humberside Deanery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2SF, UK.
Department of Obstetrics and Gynaecology, Jessop Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2SF, UK.
Best Pract Res Clin Obstet Gynaecol. 2021 Jun;73:22-39. doi: 10.1016/j.bpobgyn.2021.03.006. Epub 2021 Mar 18.
This chapter explores ways to reduce the risk of severe acute respiratory syndrome coronavirus-2 transmission to women and staff within gynaecology outpatient clinics. The likely routes of transmission are discussed, namely through droplets, aerosols and fomites. Using the 'hierarchy of control' categories, elimination, substitution, engineering, administration and personal protective equipment, practical strategies for modifying virus exposure are presented. The management of specific clinical conditions are reviewed based on advice prepared by the specialist societies in conjunction with each other and the Royal College of Obstetricians and Gynaecologists. The need to maintain at least a minimal level of gynaecological services is recognised and that this should provide safe, equitable and effective care. Ways to reduce clinic attendance are discussed with the substitution of face-to-face with remote consultations and when this is relevant. Current recommendations for ambulatory procedures, which include colposcopy and hysteroscopy, are considered so that best use is made of reduced resources.
本章探讨了降低妇科门诊中新冠病毒传播给妇女和医护人员风险的方法。讨论了可能的传播途径，即飞沫、气溶胶和接触传播。使用“控制层次”类别，即消除、替代、工程、管理和个人防护设备，提出了改变病毒暴露的实用策略。根据专业学会相互之间以及与皇家妇产科医师学院共同制定的建议，审查了特定临床情况的管理。认识到需要维持至少最低限度的妇科服务水平，并且应该提供安全、公平和有效的护理。讨论了减少就诊次数的方法，包括用远程咨询替代面对面咨询。考虑了当前对门诊手术的建议，包括阴道镜检查和宫腔镜检查，以便更好地利用减少的资源。
