Management Guidelines for Obstetric Patients and Neonates Born to Mothers With Suspected or Probable Severe Acute Respiratory Syndrome (SARS)
Identifieur interne : 001206 ( Pmc/Corpus ); précédent : 001205; suivant : 001207Management Guidelines for Obstetric Patients and Neonates Born to Mothers With Suspected or Probable Severe Acute Respiratory Syndrome (SARS)
Auteurs : Cynthia MaxwellSource :
- Journal of Obstetrics and Gynaecology Canada [ 1701-2163 ] ; 2009.
Abstract
This document summarizes the limited experience of SARS in pregnancy and suggests guidelines for management.
Cases reported from Asia suggest that maternal and fetal outcomes are worsened by SARS during pregnancy.
Medline was searched for relevant articles published in English from 2000 to 2007. Case reports were reviewed and expert opinion sought.
Recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care.
The Society of Obstetricians and Gynaecologists of Canada.
All hospitals should have infection control systems in place to ensure that alerts regarding changes in exposure risk factors for SARS or other potentially serious communicable diseases are conveyed promptly to clinical units, including the labour and delivery unit. (III-C) At times of SARS outbreaks, all pregnant patients being assessed or admitted to the hospital should be screened for symptoms of and risk factors for SARS. (III-C) Upon arrival in the labour triage unit, pregnant patients with suspected and probable SARS should be placed in a negative pressure isolation room with at least 6 air exchanges per hour. All labour and delivery units caring for suspected and probable SARS should have available at least one room in which patients can safely labour and deliver while in need of airborne isolation. (III-C) If possible, labour and delivery (including operative delivery or Caesarean section) should be managed in a designated negative pressure isolation room, by designated personnel with specialized infection control preparation and protective gear. (III-C) Either regional or general anaesthesia may be appropriate for delivery of patients with SARS. (III-C) Neonates of mothers with SARS should be isolated in a designated unit until the infant has been well for 10 days, or until the mother’s period of isolation is complete. The mother should not breastfeed during this period. (III-C) A multidisciplinary team, consisting of obstetricians, nurses, pediatricians, infection control specialists, respiratory therapists, and anaesthesiologists, should be identified in each unit and be responsible for the unit organization and implementation of SARS management protocols. (III-C) Staff caring for pregnant SARS patients should not care for other pregnant patients. Staff caring for pregnant SARS patients should be actively monitored for fever and other symptoms of SARS. Such individuals should not work in the presence of any SARS symptoms within 10 days of exposure to a SARS patient. (III-C) All health care personnel, trainees, and support staff should be trained in infection control management and containment to prevent spread of the SARS virus. (III-A) Regional health authorities in conjunction with hospital staff should consider designating specific facilities or health care units, including primary, secondary, or tertiary health care centres, to care for patients with SARS or similar illnesses. (III-A)
Url:
DOI: 10.1016/S1701-2163(16)34155-X
PubMed: 19497157
PubMed Central: 7129583
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PMC:7129583Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Management Guidelines for Obstetric Patients and Neonates Born to Mothers With Suspected or Probable Severe Acute Respiratory Syndrome (SARS)</title><author><name sortKey="Maxwell, Cynthia" sort="Maxwell, Cynthia" uniqKey="Maxwell C" first="Cynthia" last="Maxwell">Cynthia Maxwell</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19497157</idno><idno type="pmc">7129583</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129583</idno><idno type="RBID">PMC:7129583</idno><idno type="doi">10.1016/S1701-2163(16)34155-X</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">001206</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001206</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Management Guidelines for Obstetric Patients and Neonates Born to Mothers With Suspected or Probable Severe Acute Respiratory Syndrome (SARS)</title><author><name sortKey="Maxwell, Cynthia" sort="Maxwell, Cynthia" uniqKey="Maxwell C" first="Cynthia" last="Maxwell">Cynthia Maxwell</name></author></analytic><series><title level="j">Journal of Obstetrics and Gynaecology Canada</title><idno type="ISSN">1701-2163</idno><idno type="eISSN">1701-2163</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>This document summarizes the limited experience of SARS in pregnancy and suggests guidelines for management.</p></sec><sec><title>Outcomes</title><p>Cases reported from Asia suggest that maternal and fetal outcomes are worsened by SARS during pregnancy.</p></sec><sec><title>Evidence</title><p>Medline was searched for relevant articles published in English from 2000 to 2007. Case reports were reviewed and expert opinion sought.</p></sec><sec><title>Values</title><p>Recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care.</p></sec><sec><title>Sponsors</title><p>The Society of Obstetricians and Gynaecologists of Canada.</p></sec><sec><title>Recommendations</title><p><list list-type="simple" id="l0010"><list-item id="o1025"><label>1.</label><p id="p1735">All hospitals should have infection control systems in place to ensure that alerts regarding changes in exposure risk factors for SARS or other potentially serious communicable diseases are conveyed promptly to clinical units, including the labour and delivery unit. (III-C)</p></list-item><list-item id="o1030"><label>2.</label><p id="p1740">At times of SARS outbreaks, all pregnant patients being assessed or admitted to the hospital should be screened for symptoms of and risk factors for SARS. (III-C)</p></list-item><list-item id="o1035"><label>3.</label><p id="p1745">Upon arrival in the labour triage unit, pregnant patients with suspected and probable SARS should be placed in a negative pressure isolation room with at least 6 air exchanges per hour. All labour and delivery units caring for suspected and probable SARS should have available at least one room in which patients can safely labour and deliver while in need of airborne isolation. (III-C)</p></list-item><list-item id="o1040"><label>4.</label><p id="p1750">If possible, labour and delivery (including operative delivery or Caesarean section) should be managed in a designated negative pressure isolation room, by designated personnel with specialized infection control preparation and protective gear. (III-C)</p></list-item><list-item id="o1045"><label>5.</label><p id="p1755">Either regional or general anaesthesia may be appropriate for delivery of patients with SARS. (III-C)</p></list-item><list-item id="o1050"><label>6.</label><p id="p1760">Neonates of mothers with SARS should be isolated in a designated unit until the infant has been well for 10 days, or until the mother’s period of isolation is complete. The mother should not breastfeed during this period. (III-C)</p></list-item><list-item id="o1055"><label>7.</label><p id="p1765">A multidisciplinary team, consisting of obstetricians, nurses, pediatricians, infection control specialists, respiratory therapists, and anaesthesiologists, should be identified in each unit and be responsible for the unit organization and implementation of SARS management protocols. (III-C)</p></list-item><list-item id="o1060"><label>8.</label><p id="p1770">Staff caring for pregnant SARS patients should not care for other pregnant patients. Staff caring for pregnant SARS patients should be actively monitored for fever and other symptoms of SARS. Such individuals should not work in the presence of any SARS symptoms within 10 days of exposure to a SARS patient. (III-C)</p></list-item><list-item id="o1065"><label>9.</label><p id="p1775">All health care personnel, trainees, and support staff should be trained in infection control management and containment to prevent spread of the SARS virus. (III-A)</p></list-item><list-item id="o1070"><label>10.</label><p id="p1780">Regional health authorities in conjunction with hospital staff should consider designating specific facilities or health care units, including primary, secondary, or tertiary health care centres, to care for patients with SARS or similar illnesses. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Obstet Gynaecol Can</journal-id><journal-id journal-id-type="iso-abbrev">J Obstet Gynaecol Can</journal-id><journal-title-group><journal-title>Journal of Obstetrics and Gynaecology Canada</journal-title></journal-title-group><issn pub-type="ppub">1701-2163</issn><issn pub-type="epub">1701-2163</issn><publisher><publisher-name>Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19497157</article-id><article-id pub-id-type="pmc">7129583</article-id><article-id pub-id-type="publisher-id">S1701-2163(16)34155-X</article-id><article-id pub-id-type="doi">10.1016/S1701-2163(16)34155-X</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Management Guidelines for Obstetric Patients and Neonates Born to Mothers With Suspected or Probable Severe Acute Respiratory Syndrome (SARS)</article-title></title-group><contrib-group><contrib contrib-type="author" id="au2200"><name><surname>Maxwell</surname><given-names>Cynthia</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1626">Toronto ON</aff><contrib-group><contrib contrib-type="author" id="au2205"><name><surname>McGeer</surname><given-names>Alison</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1627">Toronto ON</aff><contrib-group><contrib contrib-type="author" id="au2210"><name><surname>Tai</surname><given-names>Kin Fan Young</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1628">Toronto ON</aff><contrib-group><contrib contrib-type="author" id="au2215"><name><surname>Sermer</surname><given-names>Mathew</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1629">Toronto ON</aff><contrib-group><contrib contrib-type="author"><collab>MATERNAL FETAL MEDICINE COMMITTEE<contrib-group><contrib contrib-type="author" id="au2220"><name><surname>Farine</surname><given-names>Dan</given-names></name><degrees>MD</degrees><role>Chair</role></contrib></contrib-group><aff id="af1630">Toronto ON</aff><contrib-group><contrib contrib-type="author" id="au2225"><name><surname>Basso</surname><given-names>Melanie</given-names></name><degrees>RN</degrees></contrib></contrib-group><aff id="af1631">Vancouver BC</aff><contrib-group><contrib contrib-type="author" id="au2230"><name><surname>Delisle</surname><given-names>Marie-France</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1632">Vancouver BC</aff><contrib-group><contrib contrib-type="author" id="au2235"><name><surname>Hudon</surname><given-names>Lynda</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1633">Montreal QC</aff><contrib-group><contrib contrib-type="author" id="au2240"><name><surname>Menticoglou</surname><given-names>Savas</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1634">Winnipeg MB</aff><contrib-group><contrib contrib-type="author" id="au2245"><name><surname>Mundle</surname><given-names>William</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1635">Windsor ON</aff><contrib-group><contrib contrib-type="author" id="au2250"><name><surname>Ouellet</surname><given-names>Annie</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1636">Sherbrooke QC</aff></collab></contrib></contrib-group><contrib-group><contrib contrib-type="author"><collab>INFECTIOUS DISEASE COMMITTEE<contrib-group><contrib contrib-type="author" id="au2255"><name><surname>Yudin</surname><given-names>Mark H.</given-names></name><degrees>MD</degrees><role>Chair</role></contrib></contrib-group><aff id="af1637">Toronto ON</aff><contrib-group><contrib contrib-type="author" id="au2260"><name><surname>Boucher</surname><given-names>Marc</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1638">Montreal QC</aff><contrib-group><contrib contrib-type="author" id="au2265"><name><surname>Castillo</surname><given-names>Eliana</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1639">Vancouver BC</aff><contrib-group><contrib contrib-type="author" id="au2270"><name><surname>Cormier</surname><given-names>Beatrice</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1640">Montreal QC</aff><contrib-group><contrib contrib-type="author" id="au2275"><name><surname>Gruslin</surname><given-names>Andrée</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1641">Ottawa ON</aff><contrib-group><contrib contrib-type="author" id="au2280"><name><surname>Money</surname><given-names>Deborah M.</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1642">Vancouver BC</aff><contrib-group><contrib contrib-type="author" id="au2285"><name><surname>Murphy</surname><given-names>Kellie</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1643">Toronto ON</aff><contrib-group><contrib contrib-type="author" id="au2290"><name><surname>Paquet</surname><given-names>Caroline</given-names></name><degrees>RM</degrees></contrib></contrib-group><aff id="af1644">Trois-Rivières QC</aff><contrib-group><contrib contrib-type="author" id="au2295"><name><surname>Steenbeek</surname><given-names>Audrey</given-names></name><degrees>RN</degrees></contrib></contrib-group><aff id="af1645">Halifax NS</aff><contrib-group><contrib contrib-type="author" id="au2300"><name><surname>Eyk</surname><given-names>Nancy Van</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1646">Halifax NS</aff><contrib-group><contrib contrib-type="author" id="au2305"><name><surname>van Schalkwyk</surname><given-names>Julie</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1647">Vancouver BC</aff><contrib-group><contrib contrib-type="author" id="au2310"><name><surname>Wong</surname><given-names>Thomas</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff id="af1648">Ottawa ON</aff></collab></contrib></contrib-group><pub-date pub-type="pmc-release"><day>24</day><month>2</month><year>2016</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>4</month><year>2009</year></pub-date><pub-date pub-type="epub"><day>24</day><month>2</month><year>2016</year></pub-date><volume>31</volume><issue>4</issue><fpage>358</fpage><lpage>364</lpage><permissions><copyright-statement>© 2009 Society of Obstetricians and Gynaecologists of Canada</copyright-statement><copyright-year>2009</copyright-year><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract id="ab1760"><sec><title>Objective</title><p>This document summarizes the limited experience of SARS in pregnancy and suggests guidelines for management.</p></sec><sec><title>Outcomes</title><p>Cases reported from Asia suggest that maternal and fetal outcomes are worsened by SARS during pregnancy.</p></sec><sec><title>Evidence</title><p>Medline was searched for relevant articles published in English from 2000 to 2007. Case reports were reviewed and expert opinion sought.</p></sec><sec><title>Values</title><p>Recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care.</p></sec><sec><title>Sponsors</title><p>The Society of Obstetricians and Gynaecologists of Canada.</p></sec><sec><title>Recommendations</title><p><list list-type="simple" id="l0010"><list-item id="o1025"><label>1.</label><p id="p1735">All hospitals should have infection control systems in place to ensure that alerts regarding changes in exposure risk factors for SARS or other potentially serious communicable diseases are conveyed promptly to clinical units, including the labour and delivery unit. (III-C)</p></list-item><list-item id="o1030"><label>2.</label><p id="p1740">At times of SARS outbreaks, all pregnant patients being assessed or admitted to the hospital should be screened for symptoms of and risk factors for SARS. (III-C)</p></list-item><list-item id="o1035"><label>3.</label><p id="p1745">Upon arrival in the labour triage unit, pregnant patients with suspected and probable SARS should be placed in a negative pressure isolation room with at least 6 air exchanges per hour. All labour and delivery units caring for suspected and probable SARS should have available at least one room in which patients can safely labour and deliver while in need of airborne isolation. (III-C)</p></list-item><list-item id="o1040"><label>4.</label><p id="p1750">If possible, labour and delivery (including operative delivery or Caesarean section) should be managed in a designated negative pressure isolation room, by designated personnel with specialized infection control preparation and protective gear. (III-C)</p></list-item><list-item id="o1045"><label>5.</label><p id="p1755">Either regional or general anaesthesia may be appropriate for delivery of patients with SARS. (III-C)</p></list-item><list-item id="o1050"><label>6.</label><p id="p1760">Neonates of mothers with SARS should be isolated in a designated unit until the infant has been well for 10 days, or until the mother’s period of isolation is complete. The mother should not breastfeed during this period. (III-C)</p></list-item><list-item id="o1055"><label>7.</label><p id="p1765">A multidisciplinary team, consisting of obstetricians, nurses, pediatricians, infection control specialists, respiratory therapists, and anaesthesiologists, should be identified in each unit and be responsible for the unit organization and implementation of SARS management protocols. (III-C)</p></list-item><list-item id="o1060"><label>8.</label><p id="p1770">Staff caring for pregnant SARS patients should not care for other pregnant patients. Staff caring for pregnant SARS patients should be actively monitored for fever and other symptoms of SARS. Such individuals should not work in the presence of any SARS symptoms within 10 days of exposure to a SARS patient. (III-C)</p></list-item><list-item id="o1065"><label>9.</label><p id="p1775">All health care personnel, trainees, and support staff should be trained in infection control management and containment to prevent spread of the SARS virus. (III-A)</p></list-item><list-item id="o1070"><label>10.</label><p id="p1780">Regional health authorities in conjunction with hospital staff should consider designating specific facilities or health care units, including primary, secondary, or tertiary health care centres, to care for patients with SARS or similar illnesses. (III-A)</p></list-item></list></p></sec></abstract><kwd-group id="kws0010"><title>Key Words</title><kwd>Severe acute respiratory syndrome (SARS)</kwd><kwd>pregnancy</kwd><kwd>perinatal morbidity</kwd><kwd>perinatal mortality</kwd><kwd>maternal morbidity</kwd><kwd>maternal mortality</kwd><kwd>acute respiratory distress syndrome (ARDS)</kwd><kwd>neonatal care</kwd></kwd-group></article-meta></front><back><ref-list id="bib0010"><title>REFERENCES</title><ref id="bb1305"><label>1.</label><mixed-citation publication-type="other" id="or0025">World Health Organization. WHO guidelines for the global surveillance of severe acute respiratory syndrome (SARS). Available at: <ext-link ext-link-type="uri" xlink:href="http://www.who.int/csr/sars/en/index.html" id="ir0060">http://www.who.int/csr/sars/en/index.html</ext-link>. 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New grades for recommendations from the Canadian Task Force on Preventive Health Care</article-title><source>CMAJ</source><volume>169</volume><issue>3</issue><year>2003</year><fpage>207</fpage><lpage>208</lpage><pub-id pub-id-type="pmid">12900479</pub-id></element-citation></ref></ref-list><fn-group><fn id="d32e449"><p id="np0010">This Clinical Practice Guideline has been prepared by the Maternal Fetal Medicine Committee, reviewed by the Infectious Disease Committee, and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada.</p></fn><fn id="d32e452"><p id="np0030">Disclosure statements have been received from all members of the committees.</p></fn><fn id="d32e455"><p id="np0040"><bold>This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the SOGC.</bold></p></fn></fn-group></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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