ACOG

Practice Advisory: Novel Coronavirus 2019 (COVID-19)

Practice Advisory

• Travel

• Due to the current risk of COVID-19, CDC is continually updating travel recommendations. Please see CDC’s Coronavirus Disease 2019 Information for Travel page for the most up to date information

• Additional travel advisories or restrictions may be implemented globally and locally within the United States depending on community spread.

• Testing

• Testing is currently occurring at state and local public health laboratories in 50 states and the District of Columbia.

• Ob-gyns and other health care practitioners should contact their local and/or state health department for guidance on testing persons under investigation.

• Pregnant Women

• The American College of Obstetricians and Gynecologists & the Society for Maternal-Fetal Medicine have developed an algorithm to aid practitioners in assessing & managing pregnant women with suspect.

• At this time, very little is known about COVID-19, particularly related to its effect on pregnant women and infants.

• And there currently are no recommendations specific to pregnant women regarding the evaluation or management of COVID-19.

• Community Mitigation Efforts

• Community mitigation efforts to control the spread of COVID-19 are being implemented across the United States.

• Infection Prevention and Control in Inpatient Obstetric Care Settings

• The CDC has published Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings.

• These considerations apply to health care facilities providing obstetric care for pregnant patients with confirmed COVID-19 or pregnant persons under investigation (PUI) in inpatient obstetric health

• The American College of Obstetricians and Gynecologists encourages physicians and other obstetric care practitioners to read and familiarize themselves with the complete list of recommendations.

• Key highlights from the recommendations include:

• Health care practitioners should promptly notify infection control personnel at their facility of the anticipated arrival of a pregnant patient who has confirmed COVID-19 or is a PUI.

• Patients with known or suspected COVID-19 should be cared for in a single-person room with the door closed. Airborne Infection Isolation Rooms should be reserved for patients undergoing aerosol-genera

• Facemasks are an acceptable alternative when the supply chain of respirators cannot meet the demand. During this time, available respirators should be prioritized for procedures

• Infants born to mothers with confirmed COVID-19 should be considered PUIs. As such, these infants should be isolated according to the Infection Prevention and Control Guidance for PUIs.

• To reduce the risk of transmission of the virus that causes COVID-19 from the mother to the newborn, facilities should consider temporarily separating (eg, separate rooms) the mother who has confirmed

• Discharge for postpartum women should follow recommendations described in the Interim Considerations for Disposition of Hospitalized Patients with COVID-19.

• Due to the limited data on COVID-19, these recommendations are largely based on infection prevention and control considerations for other respiratory viruses such as influenza, SARS-CoV and MERS-CoV

• Breastfeeding

• The CDC has developed Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation for COVID-19.

• There are rare exceptions when breastfeeding or feeding expressed breast milk is not recommended.

• In limited case series reported to date, no evidence of virus has been found in the breast milk of women infected with COVID-19.

• Additional Information

• Currently, health officials are emphasizing that seasonal influenza remains a persistent concern for the U.S. population.

• Influenza activity continues to be high across the US, and health care practitioners are encouraged to continue offering influenza vaccine to their unvaccinated patients, particularly pregnant women.

• The American College of Obstetricians and Gynecologists will continue to closely monitor the evolution of the 2019 novel coronavirus (COVID-19) in collaboration with the CDC.