Perinatal Dönemde Koronavirüs Hastalığı 2019 Yönetimi

Year 2020, Volume: 11 Issue: 4, 475 - 485, 31.12.2020

Aslı Er Korucu , Fatma Uslu Şahan , Füsun Terzioğlu

Abstract

Aralık 2019’da Çin’de ortaya çıkan Koronavirüs Hastalığı 2019 (COVID-19), Şiddetli Akut Solunum Sendromu Koronavirüs-2'nin (SARS-CoV-2) neden olduğu bulaşıcılığı yüksek bir hastalıktır. Mart 2020 tarihinde Türkiye’de de ortaya çıkan COVID-19, Dünya Sağlık Örgütü tarafından pandemi olarak ilan edilmiştir. Dünya nüfusu bu salgın nedeniyle, sağlık ihtiyaçlarına yönelik dramatik değişikliklere tanıklık etmektedir. Gebeler, bağışıklık sisteminde ve anatomilerinde meydana gelen değişikliklerden dolayı virüse karşı daha duyarlıdır. Bu nedenle COVID-19 salgını gebelerde ciddi sağlık sonuçları ortaya çıkarabilir. Literatürde, gebelik, doğum ve doğum sonrası süreçlerde COVID-19 olan gebe kadınların klinik görünümü ve perinatal sonuçları hakkında sınırlı veriler bulunmaktadır. Gebe kadında COVID-19’dan şüphelenilmesi veya doğrulanması durumunda; doğumun zamanlamasının belirlenmesinde, sezaryen endikasyonlarının değerlendirilmesinde, enfeksiyonu önlemek için doğum odasının hazırlanmasında, anestezi tipinin seçilmesinde daha dikkatli olunması önerilmektedir. Mevcut sınırlı kanıtlar göz önüne alındığında, yenidoğanın ve annenin özel bakımının gerekmediği doğum sonrası dönemde birlikte olmaları tavsiye edilmektedir. Anne sütü bir bulaşma aracı olarak kabul edilmemektedir. Ayrıca anne ve bebeğin ayrılması, emzirme ve anne bebek bağlanması üzerindeki potansiyel zararlı etkileri nedeniyle önerilmemektedir. COVID-19 ile enfekte olan bir gebenin, maternal ve fetal/yenidoğan morbiditesi ve mortalitesini azaltmak için multidisipliner bir ekip tarafından obstetrik bakımın verilmesi oldukça önemlidir. Multidisipliner ekibin bir parçası olan hemşire ve ebeler, bakım sürecinde kadınlar ile en uzun süre birlikte olan sağlık profesyoneli olmaları nedeniyle anne ve fetüs/yenidoğanın durumunda meydana gelebilecek değişiklikleri erken dönemde belirleyebilmekte ve bu şekilde ekibinin karar verme sürecine güçlü bir destek oluşturabilmektedir. Bu makalede tüm dünyada yayılarak küresel bir boyut kazanan COVID-19’un gebelik, doğum ve doğum sonrası süreçlere etkilerinin ve hastalığın yönetiminin literatür eşliğinde tartışılması amaçlanmıştır.

Keywords

Antenatal Bakım, COVID-19, Perinatal Dönem, Salgın, SARS-CoV-2, Yenidoğan

Coronavirus Disease 2019 Management in the Perinatal Period

Abstract

Coronavirus disease 2019 (COVID-19), which appears in China in December 2019, is a highly contagious disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). COVID-19, which also appeared in Turkey in March 2020, has been declared a pandemic by the World Health Organization. Dramatic changes to health needs is witnessed due to COVID-19Due to changes in their immune system and anatomy, pregnant women are more sensitive to COVID-19 which may cause serious health consequences. In the literature, limited data are available on the clinical and perinatal outcomes of pregnant women infected with COVID-19 in pregnancy, delivery and postpartum processes. In case pregnant woman is suspected or confirmed of COVID-19; it is recommended to be more careful in determining the timing of delivery, evaluating the cesarean indications, preparing the delivery room to prevent infection, and choosing the type of anesthesia. Given the limited evidence available, Unless special care is not required, the newborn and mother should not be separated in the postpartum period to prevent potential harmful effects on breastfeeding and mother infant attachment. Breast milk is not considered a means of contamination. It is vital to offer an obstetric care given by a multidisciplinary team to a pregnant woman infected with COVID-19 to reduce maternal and fetal/neonatal morbidity and mortality. Nurses and midwives, who are part of the multidisciplinary team, can identify variations in the condition of the mother and fetus/newborn in early stages owing to spending longest time in the care process of women as a health professionals, consequently contribute a strong support to the team's decision-making process. In this article, it is aimed to discuss the effects of COVID-19, which becomes a global phenomena by spreading all over the world, on pregnancy, birth and postpartum processes and management of the disease in the light of the literature.

Keywords

Antenatal Care, COVID-19, Epidemic, SARS-CoV-2, Newborn, Perinatal Period

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