RESUMEN
As we confront COVID-19, the global public health emergency of our times, new knowledge is emerging that, combined with information from prior epidemics, can provide insights on how to manage this threat in specific patient populations. Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), both caused by coronaviruses, caused serious respiratory illness in pregnant women that resulted in adverse perinatal outcomes. Thus far, COVID-19 appears to follow a mild course in the vast majority of pregnant women. A significant proportion of pregnant women appear to be asymptomatic carriers of SARS-CoV-2. However, there is limited information on how COVID-19 impacts the fetus and whether vertical transmission occurs. While these knowledge gaps are addressed, it is important to recognize the highly efficient transmission characteristics of SARS-C0V-2 and its potential for causing serious disease in vulnerable individuals, including health care workers. This review provides perspectives from a single center in New York City, the epicenter of the pandemic within the United States. It offers an overview of the preparations required for deliveries of newborns of mothers with COVID-19 and the management of neonates with particular emphasis on those born with complex issues.
Asunto(s)
COVID-19 , Anomalías Congénitas/terapia , Cuidado Intensivo Neonatal/métodos , Complicaciones Infecciosas del Embarazo , Enfermería de Práctica Avanzada , Prueba de COVID-19 , Atresia Esofágica/terapia , Oxigenación por Membrana Extracorpórea , Femenino , Cardiopatías Congénitas/terapia , Hernias Diafragmáticas Congénitas/terapia , Humanos , Recién Nacido , Control de Infecciones , Transmisión Vertical de Enfermedad Infecciosa , Cuidado Intensivo Neonatal/organización & administración , Neonatólogos , Enfermeras Neonatales , Planificación de Atención al Paciente , Grupo de Atención al Paciente/organización & administración , Aislamiento de Pacientes , Aisladores de Pacientes , Embarazo , Procedimientos de Cirugía Plástica , Resucitación/métodos , SARS-CoV-2 , Factores de Tiempo , Fístula Traqueoesofágica/terapiaRESUMEN
The current pandemic has driven the medical community to adapt quickly to unprecedented challenges. Among these challenges is the need to minimize staff exposure to COVID-19 during neonatal cardiac procedures. In this report, we describe measures we have taken to protect health care workers while ensuring successful outcomes. These measures include wearing appropriate personal protective equipment, physical distancing, designating separate delivery and transport teams, and limiting the number of providers in direct contact with any patient who is infected or whose infection status is unknown. LEARNING OBJECTIVES: 1.To understand specific challenges caused by the COVID-19 pandemic for patients with congenital heart disease needing urgent neonatal intervention.2.To recognize measures that can be taken to minimize health care workers' exposures to the virus during high-risk neonatal cardiac procedures.3.To review the management of neonates with d-transposition of the great arteries and inadequate mixing.