[Obstetric Anesthesia During the SARS-CoV-2 Pandemic - a Brief Overview of Published Recommendations for Action by National and International Specialist Societies and Committees].
Identifieur interne : 000055 ( PubMed/Curation ); précédent : 000054; suivant : 000056[Obstetric Anesthesia During the SARS-CoV-2 Pandemic - a Brief Overview of Published Recommendations for Action by National and International Specialist Societies and Committees].
Auteurs : Peter Kranke ; Stephanie Weibel ; Magdalena Sitter ; Patrick Meybohm ; Thierry GirardSource :
- Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS [ 1439-1074 ] ; 2020.
Descripteurs français
- KwdFr :
- Anesthésie obstétricale, Complications de la grossesse et maladies infectieuses (), Femelle, Grossesse, Humains, Infections à coronavirus (), Infections à coronavirus (transmission), Pandémies (), Pneumopathie virale (), Pneumopathie virale (transmission), Transmission de maladie infectieuse du professionnel de santé au patient.
- MESH :
English descriptors
- KwdEn :
- Anesthesia, Obstetrical, Betacoronavirus, Coronavirus Infections (complications), Coronavirus Infections (prevention & control), Coronavirus Infections (transmission), Female, Humans, Infectious Disease Transmission, Professional-to-Patient, Pandemics (prevention & control), Pneumonia, Viral (complications), Pneumonia, Viral (prevention & control), Pneumonia, Viral (transmission), Pregnancy, Pregnancy Complications, Infectious (prevention & control).
- MESH :
- complications : Coronavirus Infections, Pneumonia, Viral.
- prevention & control : Coronavirus Infections, Pandemics, Pneumonia, Viral, Pregnancy Complications, Infectious.
- transmission : Coronavirus Infections, Pneumonia, Viral.
- Anesthesia, Obstetrical, Betacoronavirus, Female, Humans, Infectious Disease Transmission, Professional-to-Patient, Pregnancy.
Abstract
The most common human corona viruses cause common colds. But three of these viruses cause more serious, acute diseases; Middle East Respiratory Syndrome (MERS by MERS-CoV), Severe Acute Respiratory Syndrome (SARS) by SARS-CoV and COVID-19 by SARS-CoV-2. The current outbreak was classified by the WHO as a "global public health emergency". Despite all efforts to reduce the surgical lists and to cancel or postpone non-time-critical surgical interventions, some surgical and anesthetic interventions outside of intensive care medicine are still necessary and must be performed. This is particularly true for obstetric interventions and neuraxial labor analgesia. Workload in the delivery room is presumably not going to decrease and planned cesarean sections cannot be postponed. In the meantime, the clinical course and outcome of some COVID-19 patients with an existing pregnancy or peripartum courses have been reported. There are already numerous recommendations from national and international bodies regarding the care of such patients. Some of these recommendations will be summarized in this manuscript. The selection of aspects should by no means be seen as a form of prioritization. The general treatment principles in dealing with COVID-19 patients and the recommendations for action in intensive care therapy also apply to pregnant and postpartum patients. In this respect, there are naturally considerable redundancies and only a few aspects apply strictly or exclusively to the cohort of obstetric patients. In summary, at present it must be stated that the general care recommendations that also apply to non-COVID-19 patients are initially valid with regard to obstetric anesthesia. Nevertheless, the special requirements on the part of hygiene and infection protection result in special circumstances that should be taken into account when caring for pregnant patients from an anesthetic point of view. These relate to both medical aspects, but also to a particular extent logistics issues with regard to spatial separation, staffing and material resources.
DOI: 10.1055/a-1144-5562
PubMed: 32274774
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<front><div type="abstract" xml:lang="en">The most common human corona viruses cause common colds. But three of these viruses cause more serious, acute diseases; Middle East Respiratory Syndrome (MERS by MERS-CoV), Severe Acute Respiratory Syndrome (SARS) by SARS-CoV and COVID-19 by SARS-CoV-2. The current outbreak was classified by the WHO as a "global public health emergency". Despite all efforts to reduce the surgical lists and to cancel or postpone non-time-critical surgical interventions, some surgical and anesthetic interventions outside of intensive care medicine are still necessary and must be performed. This is particularly true for obstetric interventions and neuraxial labor analgesia. Workload in the delivery room is presumably not going to decrease and planned cesarean sections cannot be postponed. In the meantime, the clinical course and outcome of some COVID-19 patients with an existing pregnancy or peripartum courses have been reported. There are already numerous recommendations from national and international bodies regarding the care of such patients. Some of these recommendations will be summarized in this manuscript. The selection of aspects should by no means be seen as a form of prioritization. The general treatment principles in dealing with COVID-19 patients and the recommendations for action in intensive care therapy also apply to pregnant and postpartum patients. In this respect, there are naturally considerable redundancies and only a few aspects apply strictly or exclusively to the cohort of obstetric patients. In summary, at present it must be stated that the general care recommendations that also apply to non-COVID-19 patients are initially valid with regard to obstetric anesthesia. Nevertheless, the special requirements on the part of hygiene and infection protection result in special circumstances that should be taken into account when caring for pregnant patients from an anesthetic point of view. These relate to both medical aspects, but also to a particular extent logistics issues with regard to spatial separation, staffing and material resources.</div>
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<ArticleTitle>[Obstetric Anesthesia During the SARS-CoV-2 Pandemic - a Brief Overview of Published Recommendations for Action by National and International Specialist Societies and Committees].</ArticleTitle>
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<Abstract><AbstractText>The most common human corona viruses cause common colds. But three of these viruses cause more serious, acute diseases; Middle East Respiratory Syndrome (MERS by MERS-CoV), Severe Acute Respiratory Syndrome (SARS) by SARS-CoV and COVID-19 by SARS-CoV-2. The current outbreak was classified by the WHO as a "global public health emergency". Despite all efforts to reduce the surgical lists and to cancel or postpone non-time-critical surgical interventions, some surgical and anesthetic interventions outside of intensive care medicine are still necessary and must be performed. This is particularly true for obstetric interventions and neuraxial labor analgesia. Workload in the delivery room is presumably not going to decrease and planned cesarean sections cannot be postponed. In the meantime, the clinical course and outcome of some COVID-19 patients with an existing pregnancy or peripartum courses have been reported. There are already numerous recommendations from national and international bodies regarding the care of such patients. Some of these recommendations will be summarized in this manuscript. The selection of aspects should by no means be seen as a form of prioritization. The general treatment principles in dealing with COVID-19 patients and the recommendations for action in intensive care therapy also apply to pregnant and postpartum patients. In this respect, there are naturally considerable redundancies and only a few aspects apply strictly or exclusively to the cohort of obstetric patients. In summary, at present it must be stated that the general care recommendations that also apply to non-COVID-19 patients are initially valid with regard to obstetric anesthesia. Nevertheless, the special requirements on the part of hygiene and infection protection result in special circumstances that should be taken into account when caring for pregnant patients from an anesthetic point of view. These relate to both medical aspects, but also to a particular extent logistics issues with regard to spatial separation, staffing and material resources.</AbstractText>
<CopyrightInformation>Georg Thieme Verlag KG Stuttgart · New York.</CopyrightInformation>
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<VernacularTitle>Geburtshilfliche Anästhesie während der SARS-CoV-2-Pandemie: Übersicht der Handlungsempfehlungen.</VernacularTitle>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>04</Month>
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<MedlineJournalInfo><Country>Germany</Country>
<MedlineTA>Anasthesiol Intensivmed Notfallmed Schmerzther</MedlineTA>
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<QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName>
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<OtherAbstract Type="Publisher" Language="ger"><AbstractText>Die häufigsten menschlichen Coronaviren verursachen unkomplizierte Erkältungen. Drei dieser Viren jedoch lösen schwerere, akute Krankheiten aus: das Middle East Respiratory Syndrome (MERS) durch MERS-CoV, das schwere akute respiratorische Syndrom (SARS) durch SARS-CoV und COVID-19 durch SARS-CoV-2. Seitens der WHO wurde der aktuell währende Ausbruch als „global public health emergency“ eingestuft. Trotz aller Bestrebungen, das OP-Programm zu reduzieren und nicht zeitkritische operative Eingriffe zunächst abzusagen bzw. zu verschieben, sind weiter operative Eingriffe und anästhesiologische Interventionen jenseits der Intensivversorgung notwendig. Dies trifft im besonderen Maße für geburtshilfliche Eingriffe und die neuraxiale Analgesie im Rahmen des Spontanpartus zu. So wird der Kreißsaal mutmaßlich unverändert frequentiert werden und auch „elektive Sectiones“ werden weiterhin stattfinden müssen. Mittlerweile sind klinischer Verlauf und Outcome einiger COVID-19-Patientinnen mit bestehender Schwangerschaft bzw. peripartale Verläufe berichtet worden. Es liegen bereits zahlreiche Empfehlungen nationaler und internationaler Gremien in Bezug auf die Versorgung solcher Patientinnen vor. Einige dieser Empfehlungen sollen im Rahmen dieses Beitrages kursorisch dargelegt werden. Die Auswahl der Aspekte soll keineswegs als eine Form der Priorisierung angesehen werden. Die allgemeinen Behandlungsgrundsätze im Umgang mit COVID-19-Patientinnen und die Handlungsempfehlungen zur intensivmedizinischen Therapie behalten dabei auch für schwangere und postpartale Patientinnen Gültigkeit. Insofern ergeben sich naturgemäß erhebliche Redundanzen, und nur wenige Aspekte treffen streng bzw. ausschließlich auf das Kollektiv geburtshilflicher Patientinnen zu. Zusammenfassend muss zum gegenwärtigen Zeitpunkt konstatiert werden, dass in der geburtshilflichen Anästhesie zunächst die allgemeinen Versorgungsempfehlungen gelten, die auch für Non-COVID-19-Patientinnen geltengültig sind. Gleichwohl ergeben sich durch die besonderen Vorgaben seitens der Hygiene bzw. des Infektionsschutzes besondere Umstände, die bei der Versorgung schwangerer Patientinnen berücksichtigt werden sollten. Diese betreffen neben medizinischen Fragen im Besonderen auch Fragen der Logistik in Hinblick auf eine räumliche Separierung, die Personalvorhaltung und materielle Ressourcen.</AbstractText>
</OtherAbstract>
<CoiStatement>Die Autoren geben an, dass in Hinblick auf die diskutierte Thematik keine finanziellen Interessenkonflikte bestehen. Peter Kranke ist 2. Sprecher des Arbeitskreises Geburtshilfliche Anästhesie, Mitglied des Guidelines Committee der European Society of Anaesthesiology (ESA) und Mitglied des Obstetric Anaesthesia Committee der World Federation of Societies of Anesthesiologists (WFSA).</CoiStatement>
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