Preparedness, administrative challenges for establishing obstetric services, and experience of delivering over 400 women at a tertiary care COVID-19 hospital in India

Int J Gynaecol Obstet. 2020 Nov;151(2):188-196. doi: 10.1002/ijgo.13338. Epub 2020 Sep 10.

Abstract

Objective: To provide a descriptive account of the challenges and administrative preparedness for establishing and sustaining safe obstetric services during the COVID-19 pandemic at Topiwala National Medical College & BYL Nair Charitable Hospital (NH), Mumbai, India.

Methods: The management of pregnant women with COVID-19 was implemented as per international (WHO, RCOG, ACOG) and national (Indian Council of Medical Research) recommendations and guidelines at an academic, tertiary care, COVID-19 hospital in India.

Results: Using a multidisciplinary approach and active engagement of a multispecialty team, obstetric services were provided to over 400 women with laboratory-confirmed COVID-19. A sustainable model is established for providing services to pregnant women with COVID-19 in Mumbai Metropolitan Region, India.

Conclusion: With limited resources, it is possible to set up dedicated maternity services, aligned to international guidelines, for safe pregnancy outcomes in COVID-19 settings. This COVID-19 hospital addressed the challenges and implemented several known and novel methods to establish and sustain obstetric services for women with COVID-19. The model established in the present study can be replicated in other low- and middle-income countries.

Keywords: Administrative challenges; COVID-19 disease; Cesarean; Coronavirus; Dedicated COVID-19 facility; Maternity; Personal protective equipment; SARS-CoV-2.

MeSH terms

  • Adult
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / therapy
  • Delivery, Obstetric / methods*
  • Female
  • Humans
  • India / epidemiology
  • Infection Control* / methods
  • Infection Control* / standards
  • Organizational Innovation
  • Pandemics*
  • Perinatal Care / organization & administration
  • Perinatal Care / trends
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / therapy
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Complications, Infectious* / epidemiology
  • Pregnancy Complications, Infectious* / therapy
  • Pregnancy Outcome
  • SARS-CoV-2
  • Tertiary Healthcare* / methods
  • Tertiary Healthcare* / organization & administration