ABSTRACT
Objective: To evaluate the outpatient activities of high obstetric risk during the COVID-19 pandemic. Methods: Retrospective, descriptive review of epidemiological, clinical/paraclinical factors and treatment of 102 medical records from the High Obstetric Risk clinic of the Jesus Maria Casal Ramos Araure/Acarigua University Hospital from March 11, 2020 to March 11, 2021. Results: In the year, 346 controls were carried out, 244 successive controls, 23% adolescents, 19% elderly and 58% of reproductive age;77% with some degree of formal education;57% of the municipality of Araure, the most common reason for referral in 25% want not to reproduce and 23% in previous cesarean sections;high blood pressure was the most frequent family and personal history and comorbidity;64% had a lower average gain of 6 Kgs;52% of patients were anemic on their exams, requiring iron supplements or transfusions;betamethasone was the most widely used inducer of lung maturation and amoxicillin/clavulanic antibiotic. 2 patients positive for human immunodeficiency virus, 1 primary syphilis and 2 COVID-19 were monitored and treated on an outpatient basis: 1 mild in the 1st trimester and 1 moderate in the 3rd trimester. There were no maternal deaths in the sample. Conclusion: The high obstetric risk consultation is the most effective form of articulation between the surrogate, the health services and the community that guarantees a healthy pregnancy, the place to give birth, as well as a dignified and respected treatment throughout the process. © 2022 Sociedad de Obstetricia y Ginecologia de Venezuela. All rights reserved.
ABSTRACT
Background: During the COVID-19 pandemic, telemedicine plays a critical role in providing safe, effective healthcare services, while reinforcing social distancing and optimizing the use of personal protective equipment. In this context, the Oklahoma Children's Hospital implemented virtual neonatology prenatal visits for pregnant women with a diagnosis of fetal anomalies. While tele-consultations have been broadly used with a high degree of acceptance in rural and remote areas, satisfaction has not been assessed in this particular scenario, where patients and physicians discussing sensitive healthcare information had to rapidly adjust to this new modality. Objectives: To evaluate patients' and neonatologists' satisfaction with virtual prenatal consultations in the context of the COVID-19 pandemic and to compare satisfaction levels of patients receiving virtual consultation with those receiving in-person consults. Methods: This cross-sectional study evaluated patients' and neonatologists' satisfaction with virtual consultations. Participants included pregnant women with diagnosis of fetal anomalies who received neonatology prenatal consultations at Oklahoma Children's Hospital, either in-person or through telemedicine, from May to mid-November 2020, and neonatologists providing virtual prenatal consultations in the same period. Virtual visits were delivered via Zoom Pro™. Patients and physicians who agreed to participate rated acceptability completing an anonymous 5-point Likert scale survey. Item frequencies and means for categories of items were computed by group (video-consult patients, in-person patients, physicians) and analyzed, using Welch's t for unequal sample size. Results: Overall consultation quality was rated good or excellent by 35 (100%) video-consult patients and 12 (100%) in-person patients. Patient group means computed on six 5-point Likert items about patient-physician communication did not differ significantly, video-consult: M = 28.71 (2.22); in-person consult: M = 28.92 (1.78) (p = 0.753263). All eight physicians (100%) agreed or strongly agreed that telemedicine was effective, using a 5-point Likert scale, and their combined consultation quality score computed on 10 survey questions was high: M = 46.4 (3.11). Conclusion: Despite patient inexperience with tele-consultations, the quick implementation of telemedicine, and the sensitive reason for the visit, patients and physicians were highly satisfied with virtual visits. Telemedicine is a safe, effective alternative for providing neonatology prenatal consultations for pregnant women with diagnosis of fetal anomalies during the pandemic.