open access
Management of birth, postpartum care and breastfeeding — Polish recommendations and guidelines during SARS-CoV-2 pandemic
, 1, 1
Affiliations- Department of Maternal and Child Health, Poznan University of Medical Sciences, Poland
open access
Abstract
SARS-CoV-2 pandemic is an unusual phenomenon in the modern obstetric and midwifery history. Hospital staff from the isolation wards were trained in the safety and proper use of the hazardous materials suit and the proper managing of the biohazard materials. We were not expecting the situation, so we started to create more restrictions than facilities for mothers giving birth. In the context of infection risk for the fetus, scientists still search for vertical transmission evidence, but available data are ambiguous, and more research is needed. Concerning the infant safety and to minimalize the infection risk for medical teams, the first Polish guidelines published by the national consultants in obstetrics, midwifery, neonatology, and perinatology regarding the safest formula of birth were as the following: in the case of confirmed SARS-CoV-2 infection, the cesarean section for epidemic indications should be considered, except in an advanced or rapid labor. In the lately updated consensus (14th May), it was written that because the risk of vertical and intranatal SARS-CoV-2 transmission seemed to be low, the SARS-CoV-2 infection was not the main indication to perform cesarean section for any longer. Regardless of the birth formula, the newborns are separated from their mothers immediately after the labor in Polish obstetrician hospitals. The Polish Lactation Study Centre, consociating International Breastfeeding Certified Lactation Consultant, recommends feeding the newborn with its own mother’s milk, even if she is infected with SARS-CoV-2 and isolated from her infant.
Abstract
SARS-CoV-2 pandemic is an unusual phenomenon in the modern obstetric and midwifery history. Hospital staff from the isolation wards were trained in the safety and proper use of the hazardous materials suit and the proper managing of the biohazard materials. We were not expecting the situation, so we started to create more restrictions than facilities for mothers giving birth. In the context of infection risk for the fetus, scientists still search for vertical transmission evidence, but available data are ambiguous, and more research is needed. Concerning the infant safety and to minimalize the infection risk for medical teams, the first Polish guidelines published by the national consultants in obstetrics, midwifery, neonatology, and perinatology regarding the safest formula of birth were as the following: in the case of confirmed SARS-CoV-2 infection, the cesarean section for epidemic indications should be considered, except in an advanced or rapid labor. In the lately updated consensus (14th May), it was written that because the risk of vertical and intranatal SARS-CoV-2 transmission seemed to be low, the SARS-CoV-2 infection was not the main indication to perform cesarean section for any longer. Regardless of the birth formula, the newborns are separated from their mothers immediately after the labor in Polish obstetrician hospitals. The Polish Lactation Study Centre, consociating International Breastfeeding Certified Lactation Consultant, recommends feeding the newborn with its own mother’s milk, even if she is infected with SARS-CoV-2 and isolated from her infant.
Keywords
pregnancy; newborn; SARS-CoV-2; Polish guidelines
About this articleTitle
Management of birth, postpartum care and breastfeeding — Polish recommendations and guidelines during SARS-CoV-2 pandemic
Journal
Issue
Article type
Review paper
Pages
387-391
Published online
2021-04-13
Page views
1793
Article views/downloads
1319
DOI
Pubmed
Bibliographic record
Ginekol Pol 2021;92(5):387-391.
Keywords
pregnancy
newborn
SARS-CoV-2
Polish guidelines
Authors
Katarzyna M. Wszolek
Karolina Chmaj-Wierzchowska
Maciej Wilczak
References (20)- The Medical Technologies and Rating Assesment Agency (Agencja Oceny Technologii Medycznych i Taryfikacji - AOTMiT). Recommendations in COVID-19. Polish diagnostic, therapeutic and organizational in the field of infected or being in high-risk of infection individuals care guidelines. Version 1.1 – 25.04.2020.
- Wang L, Shi Y, Xiao T, et al. Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition). Ann Transl Med. 2020.
- Royal College of Obstetricians & Gynaecologists. Coronavirus (COVID-19) Infection in Pregnancy. Information for healthcare professionals. Version 9: Published Wednesday, 13th May, 2020. https://www.rcog.org.uk/coronavirus-pregnancy (15.05.2020).
- Royal College of Obstetricians & Gynaecologists. Coronavirus (COVID-19) Infection in Pregnancy. Information for healthcare professionals. Version 11: Published Friday, 24th July, 2020. https://www.rcog.org.uk/coronavirus-pregnancy (11.09.2020).
- The Polish Government online legal acts system. http://prawo.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20200000433 (10.09.2020).
- The Polish Government online legal acts system. http://prawo.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU20200000491 (10.09.2020).
- Ziarnik M, Sosnowska J, Chmaj-Wierzchowska K, et al. COVID-19 – epidemiology, clinical picture and the management of pregnant woman and her newborn baby. Standardy Medyczne/Pediatria. 2020; 17: 118–129.
- The Polish Perinatal Medicine Association. http://ptmp.edu.pl/najnowsze-wytyczne-i-stanowisko-ekspertow-w-sprawie-zakazenia-wirusem-covid-19/ (10.09.2020).
- The national obstetrics, gynecology and perinatology consensus regarding to the perinatal care during the epidemic state. Update. Issued: 14th May 2020.
- Stanczyk P, Jachymski T, Sieroszewski P. COVID-19 during pregnancy, delivery and postpartum period based on EBM. Ginekol Pol. 2020; 91(7): 417–423.
- The Council of Ministers Regulation including the face and nose covering order. http://dziennikustaw.gov.pl/D2020000067301.pdf (12.09.2020).
- The Childbirth with Dignity Foundation official statement regarding to the Ministry of Health regulation including the covering the face and nose during the childbirth order. https://www.rodzicpoludzku.pl/aktualnosci/1416-pismo-do-ministra-zdrowia-dotyczace-obowiazku-zakrywania-ust-i-nosa-podczas-porodu.html.
- The Ministry of Health statement regarding to the Childbirth with Dignity Foundation complaint. https://www.rodzicpoludzku.pl/aktualnosci/1416-pismo-do-ministra-zdrowia-dotyczace-obowiazku-zakrywania-ust-i-nosa-podczas-porodu.html.
- The national obstetrics & gynaecology consultant, the national perinatology consultant recommendations regarding to the family birth. Update. Published: 11th May 2020. https://www.gov.pl/web/zdrowie/zalecenia-dotyczace-porodow-rodzinnych.
- Puopolo KM, Hudak ML, Kimberlin DW, Cummings J. INITIAL GUIDANCE: Management of Infants Born to Mothers with COVID-19. American Academy of Pediatrics Committee on Fetus and Newborn, Section on Neonatal Perinatal Medicine and Committee on Infectious Diseases. 2.04.2020.
- https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-on-covid-19-pregnancy-and-childbirth (15.09.2020).
- https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fpregnancy-breastfeeding.html.
- Nehring-Gogulska M, Żukowska-Rubik M. Breastfeeding and mother’s milk feeding during SARS-Cov-2 pandemic. Published: 7th May 2020. http://cnol.kobiety.med.pl/wp-content/uploads/2020/05/Algorytm-post%C4%99powania-na-czas-pandemii-8.05.2020.pdf (18.09.2020).
- The mother’s milk sourcing from the infected, hospitalized, COVID-19 mother, isolated from her infant 18.09.2020.
- Kallem VR, Sharma D. COVID 19 in neonates. J Matern Fetal Neonatal Med. 2020 [Epub ahead of print]: 1–9.
