The Impact of the COVID-19 Pandemic on Obstetric and Gynecologic Procedures and Consults at a Metropolitan Hospital in the Epicenter

ABSTRACT

Study Objective The purpose of this study was to assess the impact of the COVID-19 pandemic on surgical volume and emergency department (ED) consults across obstetric & gynecologic (OB/GYN) services at a hospital located in the national epicenter of the pandemic. Design Retrospective cohort study. Setting Tertiary-care academic medical center in a metropolitan city. Patients or Participants Women undergoing OB/GYN ED consults or surgical procedures. Interventions March 16th institutional COVID-19 mandate to hold all elective surgeries. Measurements and Main Results The volume and types of surgical cases and ED consults were compared before and after the COVID-19 mandate. During the pandemic, the volume of ED consults and GYN surgeries significantly decreased, while OB surgeries remained stable. The average weekly case volume for ED consults, GYN surgeries, and OB surgeries were 44.8, 34.8, and 38.6 cases respectively during the “pre-COVID” timeframe (February 1st to March 15th) versus 17.8, 7.2, and 40.9 cases respectively during the “post-COVID” timeframe (March 16th toApril 15th), representing a 60.3% decrease in ED consults (p=<0.01) and a 79.3% decrease in GYN surgical volume (p=<0.01). The distribution of GYN surgical case types also changed significantly during the pandemic with higher proportions of emergent surgeries for ectopics, miscarriages, and concern for cancer (p <0.001). Alternatively, the OB surgical volume and distribution of OB surgical case types remained relatively constant. Conclusion This study highlights how the pandemic has impacted the ways OB/GYN patients access and receive care. The OB surgeries remained stable during the COVID-19 pandemic reflecting the non-elective and time-sensitive nature of obstetric care. In contrast, ED consults and GYN surgeries decreased significantly. As expected, institutional policies suspending elective surgeries affected the volume and types of GYN surgeries performed during the pandemic, and the “stay-at-home” policy and personal fears of COVID-19 infection likely affected ED consult volumes.