How have the obstetricians and gynecologists struggled in the clinics during the COVID-19 pandemic?

Year 2021, Volume: 38 Issue: 4, 496 - 503, 09.10.2021

Deha Denizhan Keskin , Seda Keskin , Sedat Bostan

Abstract

Aim: As all branches of the medicine, the obstetrical and gynaecological clinical approach has been greatly affected by the pandemic. In our study, we aimed to reveal the effect of the pandemic on current obstetrics and gynaecologic clinical approach and urgency/semi-urgency evaluations of physicians related with both obstetrical and gynaecological cases.
Methods: The obstetricians in Turkey from different hospitals and clinics have completed our online questionnaire-based survey using ‘docs.google.com’. The survey questionnaire was created in three sections: Demographic, occupational analysis and thoughts about outbreak, clinical approach scale and clinical urgency scale. SPSS 22 program was used to analyze the validity and reliability of the scales.
Results: It was concluded that the pandemic process have affected the clinical approach. The effect degree was 3.79,3.15,3.72 respectively at clinical effect, clinical functioning and struggle and prevention.The specialists regardless of the year in the occupation were more affected than research assistants in terms of clinical effect (p=0.017) and also postponed obstetrical (p=0.000) and gynaecological (p=0.000) conditions more frequently. As the effect of the pandemic on clinical functioning increases, the delay of gynaecological cases increases. With the postponement of obstetrics cases, the probability of delaying gynaecological cases increases.
Conclusion: In our study, we investigated the effects of pandemic in obstetrics and gynaecology clinics during the normalization process. We think that the study will help in determining our approach to obstetrical and gynaecological cases in the future.

Keywords

pandemic, obstetrics, gynaecology, clinic approach, clinic effect, clinic urgency

Supporting Institution

There is no person or institution that provides funding for the study.

Thanks

The authors would like to thank all the obstetricians and gynaecologists who offered their time and energyto participate in the survey.

References

• 1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-733.
• 2. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novelcoronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
• 3. World Health Organization. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• 4. HabibzadehP, Stoneman EK. The Novel Coronavirus: A Bird's Eye View. Int J Occup Environ Med. 2020;11(2):65-71.
• 5. Fan Y, Zhao K, Shi ZL, et al. Bat Coronaviruses in China. Viruses. 2019;2;11(3):210.
• 6. International Committee on Taxonomy of Viruses (ICTV). Taxonomy history: Orthocoronavirinae. Available from: https://talk.ictvonline.org//taxonomy/p/taxonomy-history?taxnode_id=201851847.
• 7. Interactive visualization of the exponential spread of COVID-19. Data Repository by Johns Hopkins CSSE. Available from: https://91divoc.com/pages/COVID-visualization/
• 8. Turkey Ministry of Health coronavirus data. Available from: https://COVID19.saglik.gov.tr/
• 9. The Centers for Medicare & Medicaid Services (CMS). Recommendations on adult elective surgeries, non-essential medical, surgical, and dental procedures during COVID-19 response. Available from: https://www.cms.gov/newsroom/press-releases/cms-releasesrecommendations-adult-elective-surgeries-non-essential-medical-surgicaland- dental.
• 10. Ambulatory Surgery Center Association (ASCA).State guidance on elective surgeries.Available from: https://www.ascassociation.org/COVID-19-state.
• 11. Stephens AJ, Barton JR, Bentum NA, Blackwell SC, Sibai BM. General Guidelines in the Management of an Obstetrical Patient on the Labor and Delivery Unit during the COVID-19 Pandemic. American Journal of Perinatology. 2020;37(8):829-836..
• 12. Centers for Disease Control and Prevention (CDC). Coronavirus Disease 2019 (COVID-19). Available from: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html
• 13. World Health Organization. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/infection-prevention-and-control
• 14. The Society for Maternal-Fetal Medicine (SMFM). Katz SD, Hughes BL. Coronavirus (COVID-19) and Pregnancy: What Maternal-Fetal Medicine Subspecialists Need To Know. Available from: https://s3.amazonaws.com/cdn.smfm.org/media/2262/COVID19_PDF.pdf
• 15. American Congress of Obstetricians and Gynaecologists (ACOG). Outpatient Assessment and Management for Pregnant Women With Suspected or Confirmed Novel Coronavirus (COVID-19). Available from:https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019
• 16. The Royal College of Obstetricians and Gynaecologists (RCOG). Coronavirus (COVID-19) infection and pregnancy. Available from: https://www.rcog.org.uk/coronavirus-pregnancy
• 17. Jamieson DJ, Steinberg JP, Martinello RA, Perl TM, Rasmussen SA. Obstetricians on the Coronavirus Disease 2019 (COVID-19) Front Lines and the Confusing World of Personal Protective Equipment. Obstet Gynecol. 2020;135(6):1257-1263.
• 18. Dong, L., Tian, J., He, S., Zhu, C., Wang, J., Liu, C., & Yang, J. Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn. JAMA. 2020;323(18):1846–1848.
• 19. Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID- 19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;10.1016/S0140-6736(20)30360-3.
• 20. Poon LC, Yang H, Lee JCS, Copel JA, Leung TY, Zhang Y, Chen D, Prefumo F. ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals. Ultrasound Obstet Gynecol. 2020;55(5):700-708.
• 21. Zhang L, Jiang Y, Wei M, et al. Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province. Zhonghua Fu Chan KeZaZhi. 2020;55(0):E009.
• 22. Deprest J, Choolani M, Chervenak F, et al. Fetal Diagnosis and Therapy during the COVID-19 Pandemic: Guidance on Behalf of the International Fetal Medicine and Surgery Society. Fetal Diagn Ther. 2020;10.1159/000508254.
• 23. Joint RCOG, BSGE and BGCS guidance for the management of abnormal uterine bleeding in the evolving Coronavirus (COVID-19) pandemic. Available from: https://mk0britishsociep8d9m.kinstacdn.com/wp-content/uploads/2020/03/Joint-RCOG-BSGE-BGCS-guidance-for-management-of-abnormal-uterine-bleeding-AUB-in-the-evolving-Coronavirus-COVID-19-pandemic-300320-2.pdf
• 24. Ramirez PT, Chiva L, Eriksson AGZ, et al. COVID 19 global pandemic: Options for management of gynaecologic cancers. Int J Gynaecol Cancer 2020;0:1-3:10.1136/ijgc-2020-001419.
• 25. International Federation of Fertility Societies (IFFS) COVID-19 Task Force Statements. Available from: https://www.iffsreproduction.org/page/COVIDStatements.
• 26. European Society of Human Reproduction and Embryology (ESHRE) guidance on recommencing ART treatments. Available from: https://www.eshre.eu/Home/COVID19WG.