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Management of maternal COVID-19: considerations for anesthesiologists.
Bernstein, Kyra; Landau, Ruth.
  • Bernstein K; Department of Anesthesiology, Columbia University Irving Medical Center, New York, New York, USA.
Curr Opin Anaesthesiol ; 34(3): 246-253, 2021 Jun 01.
Article in English | MEDLINE | ID: covidwho-1191523
ABSTRACT
PURPOSE OF REVIEW To describe updates to pragmatic recommendations that were published during the first coronavirus disease 2019 (COVID-19) surge, including the current thinking about whether pregnancy worsens the severity of COVID-19. RECENT

FINDINGS:

Although a majority of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain asymptomatic or paucisymptomatic, pregnancy puts women at higher risk of severe COVID-19 and adverse birth outcomes. Pregnant and recently pregnant women are more likely to be admitted to intensive care units and receive mechanical ventilation than nonpregnant patients with COVID-19, although preexisting maternal comorbidities are significant risk factors.Early provision of neuraxial labor analgesia with a functional indwelling epidural catheter has been universally promoted, with the goal to reduce avoidable general anesthesia for cesarean delivery and mitigate risks for healthcare workers during airway manipulation. This recommendation, along with updated workflow models of anesthesia coverage, may contribute to a reduction in general anesthesia rates.

SUMMARY:

Initial recommendations to provide early neuraxial labor analgesia and avoid general anesthesia for cesarean delivery have not changed over time. Although workflows have significantly changed to allow continued patient and healthcare workers' safety, clinical anesthesia protocols for labor and delivery are essentially the same.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Labor, Obstetric / COVID-19 Type of study: Prognostic study Limits: Female / Humans / Pregnancy Language: English Journal: Curr Opin Anaesthesiol Journal subject: Anesthesiology Year: 2021 Document Type: Article Affiliation country: ACO.0000000000001001

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Labor, Obstetric / COVID-19 Type of study: Prognostic study Limits: Female / Humans / Pregnancy Language: English Journal: Curr Opin Anaesthesiol Journal subject: Anesthesiology Year: 2021 Document Type: Article Affiliation country: ACO.0000000000001001