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Postpartum Office Visit

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61. Coronavirus (COVID-19) Infection in Pregnancy

advise that women and healthy infants, not otherwise requiring neonatal care, are kept together in the immediate post-partum period. A risks / benefits discussion with neonatologists and families to individualise care in babies that may be more susceptible is recommended. We emphasise that this guidance may change as knowledge evolves. All babies born to COVID-19 positive mothers should have appropriate close monitoring and early involvement of neonatal care, where necessary. Babies born to mothers (...) available. We therefore suggest that you visit this page regularly for updates. This guidance will be kept under regular review as new evidence emerges. If you would like to suggest additional areas for this guidance to cover, any clarifications required or to submit new evidence for consideration, please email Please note, we will not be able to give individual clinical advice or information for specific organisational requirements via this email address. 1.1 The virus Novel

2020 Royal College of Obstetricians and Gynaecologists

62. Guidance for maternal medicine in the evolving coronavirus (COVID-19) pandemic

for adaptation of maternal medicine services to safely reduce face-to-face contact during the evolving coronavirus pandemic, for example by offering virtual consultations where appropriate, ensuring women are seen in one-stop clinics that cover all medical and obstetric needs in the same visit, avoiding unnecessary hospital admissions and offering new innovations, such as home monitoring of blood pressure, where it is safe to do so. • Specific advice for healthcare professionals caring for pregnant women (...) . A minority of maternal medicine clinic appointments will need to be face-to-face, primarily when the woman is having a physical interaction such as an obstetric scan, an echocardiogram, or an exchange transfusion. Face-to- face interactions should be limited by reviewing the purpose of the appointment in advance (ideally one week earlier) and ensuring that the relevant tests/treatments can all be done in a single visit. For many non-pregnant patients this is already happening as medical specialties adapt

2020 Royal College of Obstetricians and Gynaecologists

63. Depression: Perinatal

the Maternal Behavioral Health (MBH) Screening questionnaire is recommended for all pregnant and postpartum women. MBH screening is optimally performed at four visits during the pregnancy and four times through the infant's first year, at the following routine visits: Pregnancy care (In Women’s Health or Family Practice) Pediatric care (In Pediatrics or Family Practice) • First prenatal visit • 16-week visit • 32-week visitPostpartum • 7–14-day well baby visit • 4-month well baby visit • 6-month well (...) baby visit • 12-month well baby visit MBH screening has been integrated into the OB and Well Child Visit SmartSets. The MBH incorporates the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-2) questionnaire, and questions about substance abuse and domestic violence. A job aid provides details about MBH visit content and documentation (staff intranet). Note: Pregnant and postpartum women who have a current diagnosis of depression—whether made prior to pregnancy or during

2020 Kaiser Permanente Clinical Guidelines

64. Assisted Vaginal Birth

should be educated about the risk of urinary retention so that they are aware of the importance of bladder emptying in the postpartum period. [New 2020] Grade of recommendation: GPP The timing and volume of the first void urine should be monitored and documented. [New 2020] Grade of recommendation: C A post void residual should be measured if urinary retention is suspected. Grade of recommendation: ✓ Recommend that women who have received regional analgesia for a trial of assisted vaginal birth (...) be considered. [New 2020] Grade of recommendation: ✓ Do not offer single session, high‐intensity psychological interventions with an explicit focus on ‘reliving’ the trauma. [New 2020] Grade of recommendation: ✓ Offer women with persistent post‐traumatic stress disorder (PTSD) symptoms at 1 month referral to skilled professionals as per the NICE guidance on PTSD. [New 2020] Grade of recommendation: D What information should women be given for future births? Inform women that there is a high probability

2020 Royal College of Obstetricians and Gynaecologists

65. Coronavirus (COVID-19) infection and pregnancy

: Summary of previous updates 41-49 Appendix 2: Key considerations when caring for women with suspected/confirmed COVID-19 during labour and birth 50-54 References 55-613 Summary of updates Previous updates have been summarised in Appendix 2. New updates for this version of the guideline are summarised here. Version Date Summary of changes 9 13.5.20 1: Aims updated to include: The provision of safe, woman-centred care to women who are pregnant, give birth or are in the early postnatal period during (...) to review, admit and consider multidisciplinary escalation in women of BAME background.4 9 13.5.20 2.2: Removed statement that further guidance on remote consultations will be published soon, and provided reference to RCM/RCOG guidance on antenatal and postnatal care. 9 13.5.20 2.3: Changed the statement that units should consider reducing provision of induction of labour for indications that are not ‘strictly necessary’, to units should consider reducing induction of labour where this is not ‘medically

2020 Royal College of Obstetricians and Gynaecologists

66. Update on COVID-19 epidemiology and impact on medical care in children: April 2020

in community, group, and long-term care settings. Data from low-income countries are not yet widely available. It is theoretically possible that vertical transmission of COVID-19 occurs, but the studies published to date examining this route of infection either lack critical information to reach such a definitive conclusion or cannot exclude post-natal transmission from caregivers or health care workers as a possible route of infection [ ] - [ ] . Clinical disease presentation and severity Reports continue (...) Update on COVID-19 epidemiology and impact on medical care in children: April 2020 Update on COVID-19 epidemiology and impact on medical care in children: April 2020Update on COVID-19 epidemiology and impact on medical care in children: April 2020 | Canadian Paediatric Society A home for paediatricians. A voice for children and youth. Current: Update on COVID-19… Practice Point Update on COVID-19 epidemiology and impact on medical care in children: April 2020 Posted: Apr 29, 2020 The Canadian

2020 Canadian Paediatric Society

67. What asymptomatic groups of individuals should be screened for COVID-19?

, hypertension, lung diseases, diabetes, cancer, people with weakened immune systems from a medical condition or treatment, such as chemotherapy (Public Health Agency of Canada, 2020). Continuous masking and routine practices would mitigate the risk even if asymptomatic patients end up as positive. Visitors are currently restricted from hospitals with the exception of end of life, maternity/post-partum, pediatrics and outpatient/ED/Urgent Care, which allow 1 visitor at a time, thus reducing the excess (...) Medical Officer of Health that asymptomatic transmission in Alberta may be occurring more often than previously thought. • On April 17, 2020, Alberta’s Chief Medical Officer of Health announced that all residents and staff of LTC facilities that have experienced an outbreak will be eligible for SARS-CoV-2 testing, including asymptomatic individuals. • On April 27, 2020, it was announced that in the context of an outbreak shelters will be testing all clients for COVID-19, as well as symptomatic

2020 Covid-19 Ad hoc papers

68. COVID-19: Operational guidance for maintaining essential health services during an outbreak

. It complements existing and forthcoming WHO guidance on the wider implications of COVID-19 for health systems and cross-government strategies for responding to the COVID-19 outbreak, including region-specific technical guidance being developed by WHO Regional Offices. 1. Elston, J. W. T., Cartwright, C., Ndumbi, P., & Wright, J. (2017). The health impact of the 2014–15 Ebola outbreak. Public Health, 143, 60–70. 2. Parpia, A. S., Ndeffo-Mbah, M. L., Wenzel, N. S., & Galvani, A. P. (2016). Effects of response (...) will be guided by health system context and the local burden of disease, but should initially be oriented to preventing communicable disease, averting maternal and child morbidity and mortality, preventing acute exacerbations of chronic conditions by maintaining established treatment regimens, and managing emergency conditions that require time-sensitive intervention. Routine health promotion visits may be limited, and delivery of vaccinations and antenatal care will likely need to be adapted (see optimizing

2020 WHO Coronavirus disease (COVID-19) Pandemic

69. Safe nurse staffing levels in acute hospitals


2020 Belgian Health Care Knowledge Centre

70. British guideline on the management of asthma

that these equality aims are addressed in every guideline. This methodology is set out in the current version of SIGN 50, our guideline manual, which can be found at The EQIA assessment of the manual can be seen at The full report in paper form and/or alternative format is available on request from the Healthcare Improvement Scotland Equality and Diversity Officer. Every care is taken to ensure that this publication is correct in every detail (...) of inhaled corticosteroids) • assess the patient’s status with a validated symptom questionnaire, ideally corroborated by lung function tests (FEV 1 at clinic visits or by domiciliary serial peak flows to capture times with/without symptoms) • with a good symptomatic and objective response to treatment, confirm the diagnosis of asthma and record the basis on which the diagnosis was made • if the response is poor or equivocal, check inhaler technique and adherence, arrange further tests and consider

2019 SIGN

71. Towards integrated antenatal care for low-risk pregnancy

Leuven), Benoît Moons (Gynécologue- obstétricien - Site Sainte Elisabeth, CHU UCL Namur), Sophie Thunus (Institut de Recherche Santé et Société, UCLouvain) Acknowledgements: We would like to thank Inga-Maj Andersson (Programme Officer at the National Board of Health and Welfare, Stockholm) for her support in the description of the organisation of antenatal care in Sweden, Mika Gissler (Research Professor, THL National Institute for Health and Welfare, Information Department Services, Helsinki (...) ’ PERSPECTIVES 36 5.1 PARENTS’ PERSPECTIVE 36 5.1.1 Design, sampling and recruitment 36 5.1.2 Data analysis 37 5.1.3 Results 37 5.1.4 Parents’ expectations, choices and involvement in ANC 41 5.2 HEALTHCARE PROFESSIONALS’ PERSPECTIVE 42 5.2.1 Methods 42 5.2.2 Results 43 5.2.3 Professionals’ opinions regarding clinical follow-up, birth and postpartum preparation 44 5.2.4 Professionals’ opinions regarding preconception care 45 5.2.5 Professionals’ opinions about quality of ANC 46 5.2.6 Professionals’ opinions

2020 Belgian Health Care Knowledge Centre

72. Optimisation of RIZIV – INAMI lump sums for incontinence

). For women, pregnancy, delivery and parturition factors e.g. instrumental delivery and birth weight, are risk factors for UI in the post- partum period. Further, body mass has been established as an important risk factor for UI while other modifiable factors include smoking, diet, depression, constipation, urine tract infections, and strenuous exercise (e.g. jumping). Although associated with UI, they are not considered established independent risk factors. In older women, physical function and moderate (...) with age from 1.5% in children towards 50% in nursing home residents (LE 1). Risk factors for AI are not well defined in general. In the elderly at home and in nursing homes often FI is accompanied by UI (LE1) and commonly so in the cognitively impaired [9] . Patients and carers perceive the cause of the FI due to childbirth, menopause, old age, paralysis, haemorrhoids, rectal or anal surgery, neurological disorders [10] . The risk of post-partum FI is reduced by intrapartum pelvic floor education (LE

2020 Belgian Health Care Knowledge Centre

73. Drug misuse prevention: targeted interventions

or private services, including: health services, such as primary care services, community-based health services, mental health services, sexual and reproductive health services, drug and alcohol services, and school nursing and health visiting services specialist services for people in groups at risk community-based criminal justice services, including adult, youth and family justice services accident and emergency services. 1.1.2 Ensure activities targeting groups at risk are consistent with any (...) (or controlled) drugs in the UK. According to the Home Office report Drug misuse: findings from the 2015 to 2016 Crime Survey for England and Wales: Around 8% of people aged 16 to 59 had taken an illegal drug or used a substance unlawfully in the past year, and around 4% had taken one in the past month. Among young adults aged 16 to 24, this was 18% in the past year and 9% in the past month. More than one third of adults aged 16 to 59 (35%) have taken an illegal drug or used a substance unlawfully at some

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

74. Guidelines on Supraventricular Tachycardia (for the management of patients with) (Full text)

drugs that do not have the approval of governmental regulatory agencies in all countries. 2.2 Relationships with industry and other conflicts of interest It is ESC policy to sponsor position papers and Guidelines without commercial support, and all members volunteered their time. Thus, all members of the writing group, as well as the reviewers, have disclosed any potential conflicts of interest in detail. The details of these declarations will be posted on the ESC website upon publication (...) of the patient with supraventricular tachycardia Standard History, physical examination, and 12 lead ECG Full blood counts, biochemistry profile, and thyroid function An ECG during tachycardia should be sought Transthoracic echocardiography Optional Exercise tolerance testing 24 h ECG monitoring, transtelephonic monitoring, or an implantable loop recorder Myocardial ischaemia testing in patients with risk factors for coronary artery disease (including men aged >40 years and post-menopausal women) An EPS

2019 European Society of Cardiology PubMed abstract

75. Sexual Misconduct

during childbirth to be a dehu- manizing and traumatic experience (16). Patients who experience childbirth as a traumatic event are at high risk of developing depression and posttraumatic stress disorder in the postpartum period (18). Although the interpretation and generalizability of these data are lim- ited by the studies’ methods, patients’ vulnerability to perceivedsexualviolationduringchildbirthdeservesspe- cial consideration, especially given the sometimes inten- sive and acute nature (...) about patients’ health care, and ultimately be detrimental to patients’ long-term health (19, 20). Fur- thermore, an uncomfortable or traumatic experience in a physician’s office may become a major barrier to seek- ing needed health care in the future. Sexual or romantic behavior by a physician toward a current patient constitutes misconduct regardless of whether a patient appears to initiate or consent to such behavior. Physicians’ professional codes of ethics have historically precluded

2020 American College of Obstetricians and Gynecologists

76. Guidelines for the management of pregnant and breastfeeding women in the context of Ebola virus disease

reproductive-aged women with acute EVD, does being pregnant alter the outcome of the acute EVD? 2. Among pregnant women, how does acute EVD alter maternal, pregnancy, and neonatal outcomes? 3. Among EVD survivors, does being pregnant, postpartum or post-abortion alter EBOV persistence in body fluids such as breastmilk and other pregnancy-related body fluids and tissues? 4. Among women infected with EBOV, does a history of EVD alter subsequent preg- nancy outcomes?Guidelines for the management of pregnant (...) and breastfeeding women in the context of Ebola virus disease 2 Acronyms and abbreviations AFRO Regional Office for Africa (at WHO) CDC Centers for Disease Control and Prevention (the United States of America) CT cycle threshold DSMB Data and Safety Monitoring Board EBOV Ebola virus ETC Ebola treatment centre EtD evidence-to-decision EVD Ebola virus disease (acute EVD refers to laboratory-confirmed (positive viremia) and symptomatic Ebola virus disease) GCP good clinical practice GDG Guideline Development Group

2020 World Health Organisation Guidelines

77. Citizen engagement in public services in low? and middle?income countries: A mixed?methods systematic review of participation, inclusion, transparency and accountability (PITA) initiatives (Full text)

‐effectively, for example by conducting more follow‐up studies of existing trials, or by conducting ex post evaluations using natural experiments. In this review, the authors used theory‐based mixed‐methods approaches to examine a wide range of interventions promoting citizen engagement in public services governance, taking the PITA mechanism as the unit of analysis. Further synthesis research adopting this broader approach may focus on interventions to improve other domains of governance (e.g. the compact (...) the political system; within the management and administration of public sector offices and institutions; and in the ways in which public officials and service providers engage with service users (external engagement) (Waddington, Stevenson, Sonnenfeld, & Gaarder, ). In this framing, good governance interventions attempt to influence the social contract that mediates the relationships between government and citizens, regarding who has access to what power and in return for what accountability for service

2019 Campbell Collaboration PubMed abstract

78. Recommendations for good practice in Ultrasound: Oocyte retrieval

Prior to OPU 11 Equipment and consumables 12 OPU preparation (see also Box B: Before OPU-Checklist) 14 OPU procedure 19 Post-procedure care (see also BOX D: After OPU-Checklist) 23 Associated pathologies and cautions during OPU 24 Complications and risks 25 Future developments 32 Training and competence 33 Quality assurance and performance 34 Concluding remarks / discussion 35 References 36 4 The ESHRE Working group on Ultrasound in ART Arianna D’Angelo (chair) Costas Panayotidis Nazar Amso Roberto (...) instead of general anaesthesia; • decreased risk of intestinal trauma; • it can be easily learned, especially by operators trained in US; • decreased costs for patients; • and quick post-interventional recovery. However, in some patients, transabdominal ultrasound facilitated access when the ovaries were transposed or enlarged above the pelvic brim. Transabdominal-guided oocyte retrieval continues to be used at some centres for rare patients who have ovaries inaccessible by vaginal ultrasound

2019 European Society of Human Reproduction and Embryology

80. Digital platforms as effective health promotion tools

or online comparison groups • Findings were mixed for the effects of digital interventions in increasing physical activity and reducing sedentary behaviour, and only one study found a significant effect on body mass index (BMI) • Visitation and engagement with digital platforms were higher initially and declined over time, with poor repeat visitation and ongoing engagement. Question 4: What indicators are used to measure the effectiveness, reach and impact of a health promotion website or app (...) of real-time objective data collection, iterative evaluation and the need for health economic evaluation • Comprehensive evaluation frameworks should include a range of indicators measuring reach (e.g. visitation), impact (e.g. page access and viewing time; content acceptability; fidelity) and effectiveness of target behaviours (e.g. knowledge, attitudes, beliefs, target behaviour). Gaps in the evidence There is a lack of literature evaluating lunch-box websites and apps as specific types of digital

2019 Sax Institute Evidence Check

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