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1. Outpatient Assessment and Management for Pregnant Women With Suspected or Confirmed Novel Coronavirus (COVID-19)

Outpatient Assessment and Management for Pregnant Women With Suspected or Confirmed Novel Coronavirus (COVID-19) Abbreviations: ABG, arterial blood gases; CDC, Centers for Disease Control and Prevention; HIV, human immunodeficiency virus. Healthcare providers should immediately notify their local or state health department in the event of a PUI for COVID-19 and should contact and consult with their local and/or state health department for recommendations on testing PUIs for COVID-19. Outpatient (...) Assessment and Management for Pregnant Women With Suspected or Confirmed Novel Coronavirus (COVID-19) Unlike influenza and other respiratory illnesses, based on a limited number of confirmed COVID-19 cases, pregnant women do not appear to be at increased risk for severe disease. However, given the lack of data and experience with other coronaviruses such as SARS-CoV and MERS-CoV, diligence in evaluating and treating pregnant women is warranted. This algorithm is designed to aid practitioners in promptly

2020 American College of Obstetricians and Gynecologists

2. Novel coronavirus (COVID-19) Guidance for Primary Care Management of patients presenting to primary care

Novel coronavirus (COVID-19) Guidance for Primary Care Management of patients presenting to primary care Health Protection Scotland This document is uncontrolled when printed. Before use check the HPS COVID-19 page to verify this is the current version Novel coronavirus (COVID-19) Guidance for Primary Care Management of patients presenting to primary care Version 10.4 Publication date 27 March 2020 Health Protection Scotland 1 Version History Version Date Summary of changes V1.0 23/01/20 First (...) equipment 12 11.5. Carpeted flooring and soft furnishings 12 11.6. On leaving the room 13 11.7. Cleaning of communal areas 13 11.8. Attending deaths 13 12. Further information 13 Appendix 1: Contact details for local Health Protection Teams 14 Health Protection Scotland 4 Appendix 2: Putting on and removing Personal Protective Equipment (PPE) 15 Instructional video 16 Health Protection Scotland 5 1. Introduction Novel coronavirus (COVID-19) is a new is a new strain of coronavirus first identified

2020 Covid-19 Ad hoc guidelines

3. Novel Coronavirus 2019 (COVID-19)

women. For more information on seasonal influenza and recommendations for pregnant women see the and . The American College of Obstetricians and Gynecologists will continue to closely monitor the evolution of the 2019 novel coronavirus (COVID-19) in collaboration with the CDC. New and updated information will be shared as it becomes available. This Practice Advisory was developed by the American College of Obstetricians and Gynecologists’ Immunization, Infectious Disease, and Public Health (...) Novel Coronavirus 2019 (COVID-19) Novel Coronavirus 2019 (COVID-19) | ACOG Clinical Guidance Journals & Publications Patient Education Topics Featured Clinical Topics Hi, Featured Clinical Topics Clinical Guidance Novel Coronavirus 2019 (COVID-19) Practice Advisory March 2020 Jump to Resources Share By reading this page you agree to ACOG's Terms and Conditions. . The Centers for Disease Control and Prevention (CDC) has released and guidance for . Travel Due to the current risk of COVID-19, CDC

2020 American College of Obstetricians and Gynecologists

4. Novel Coronavirus (COVID-19) Management In Malaysia

Novel Coronavirus (COVID-19) Management In Malaysia Portal Rasmi Kementerian Kesihatan Malaysia Selamat Datang Ke Portal Rasmi Kementerian Kesihatan Malaysia Broadcast Pengenalan Kami Berita Soalan Lazim Pekeliling Hubungi Kami | | | Bahasa Melayu | | | | COVID-19 (Garis Panduan) Maklumat Terkini Garis Panduan Pusat Media Infografik Video Tanya Doktor GARIS PANDUAN 1. Guidelines 2019 Novel Coronavirus (COVID-19) Management In Malaysia No. 4/2020 Nama Dokumen Download Table of Content Annex 1 (...) Sampel Di Luar Waktu Pejabat, Hujung Minggu Dan Cuti Umum Annex 5a : Guidelines on Laboratory Testing For Novel Coronavirus For Patients Under Inevestigation Annex 5b : Laboratory Testing For Inpatient Annex 5c: Triple Layer Packaging Annex 6a: Health Alert Card Annex 6b: Mental Health Alert Card Annex 7: Notification Form Annex 8 : The Infection Prevention And Control (IPC) Measures Annex 9 : Management Of COVID-19 At Point Of Entry Appendix 1 : Passenger Locator Form (as per WHO/ICAO) Appendix 2

2019 Ministry of Health, Malaysia

5. Home care for patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts

Home care for patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts 1 Home care for patients with COVID-19 presenting with mild symptoms and management of their contacts Interim guidance 17 March 2020 Background WHO has developed this interim guidance to meet the need for recommendations on safe home care for patients with suspected COVID-19 who present with mild symptoms a and on public health measures related to the management (...) be triaged at the first point of contact with the health care system and that emergency treatment should be started based on disease severity. WHO has updated treatment guidelines for patients with ARI associated with COVID-19, which includes guidance for vulnerable populations (e.g., older adults, pregnant women and children). In situations where isolation in a health care facility of all cases is not possible, WHO emphasizes the prioritization of those with highest probability of poor outcomes

2020 WHO Coronavirus disease (COVID-19) Pandemic

6. Development of early warning and rapid response system for patients with novel coronavirus pneumonia (COVID-19): A research protocol. Full Text available with Trip Pro

Development of early warning and rapid response system for patients with novel coronavirus pneumonia (COVID-19): A research protocol. Coronavirus disease 2019 (COVID-19) has caused serious damage to public health. COVID-19 has no vaccine or specific therapy; its mortality rate increases significantly once patients deteriorate. Furthermore, intensive monitoring of COVID-19 is limited by insufficient medical resources and increased risks of exposure to medical staff. We therefore aim to build (...) an early warning and rapid response system (EWRRS) to address these problems.The research is designed as a prospective cohort study, to verify a dynamic and interactive evaluation system; it includes patient self-reporting, active monitoring, early alarming and treatment recommendations. Adult patients diagnosed with COVID-19 will be recruited from Sept 2020 to Aug 2021 at a tertiary contagious hospital. Patients with life expectancy <48 hours, pregnant or lactating, in immunosuppression states or end

2020 Medicine

7. A Case of 2019 Novel Coronavirus in a Pregnant Woman With Preterm Delivery. Full Text available with Trip Pro

A Case of 2019 Novel Coronavirus in a Pregnant Woman With Preterm Delivery. We present a case of a 30-week pregnant woman with the 2019 novel coronavirus (COVID-19) delivering a healthy infant with no evidence of COVID-19.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

2020 Clinical Infectious Diseases

8. Coronavirus disease 2019 (COVID-19): Pregnancy issues

Coronavirus disease 2019 (COVID-19): Pregnancy issues UpToDate It seems to us that you have your JavaScript disabled on your browser. JavaScript is required in order for our site to behave correctly. Please enable JavaScript to use our site.

2020 UpToDate

9. Coronavirus (COVID-19) Infection in Pregnancy

Xue Za Zhi 2020;49(0):E005-E05. doi: 10.3760/cma.j.cn112151-20200225-00138 4 Wang X, Zhou Z, Zhang J, et al. A case of 2019 Novel Coronavirus in a pregnant woman with pre- term delivery. Clinical Infectious Diseases 2020 doi: https://doi.org/10.1093/cid/ciaa200 5 Zhang J, Wang Y, Chen L, et al. Clinical analysis of pregnancy in second and third trimesters com- plicated severe acute respiratory syndrome. Zhonghua Fu Chan Ke Za Zhi 2003;38:516-20. 6 Travel advice: coronavirus (COVID-19) 2020 (...) Coronavirus (COVID-19) Infection in Pregnancy 1 Information for healthcare professionals Version 1: Published Monday 9 March, 2020 Coronavirus (COVID-19) Infection in Pregnancy2 Table of contents Introduction 3-5 Advice for health professionals to share with pregnant women 7-9 Advice for services caring for women with suspected or confirmed COVID-19 11-23 Advice for services caring for women following recovery from confirmed COVID-19 25 Acknowledgements 26 Flow chart to assess COVID-19 risk

2020 Royal College of Obstetricians and Gynaecologists

10. Coronavirus (COVID-19) infection and pregnancy

professionals based on a combination of available evidence, good practice and expert consensus opinion. The priorities are: (i) The reduction of transmission of COVID-19 to pregnant women. (ii) The provision of safe, personalised and woman-centred care during pregnancy, birth and the early postnatal period during the COVID-19 pandemic. (iii) The provision of safe, personalised and woman-centred care to pregnant and postnatal women with suspected/confirmed COVID-19. Please be aware that this is very much (...) is extrapolated from case reports or systematic reviews of case series, along with expert consensus opinion to develop the advice statements. Clinicians and patients are advised to be aware of the low-quality evidence on which the advice is given when using this guidance to assist decision making. 6 1.2 Epidemiology Novel coronavirus (SARS-CoV-2) is a new strain of coronavirus causing COVID-19, first identified in Wuhan City, China towards the end of 2019. 3 Other human coronavirus (HCoV) infections include

2020 Royal College of Obstetricians and Gynaecologists

11. Coronavirus (COVID-19) infection and pregnancy

?’ 12 14.10.20 2.2 Recommendations added: • Women should be advised that vaccination against influenza is safe at all gestations of pregnancy and is recommended to protect both the woman and baby from the adverse effects of becoming seriously ill with flu during pregnancy. During the COVID-19 pandemic, it is particularly important that pregnant women take up the influenza vaccine to reduce their risk of contracting flu.4 • Appointments where physical examination is not required and where (...) of available evidence, good practice and expert consensus opinion. The priorities are: (i) The reduction of transmission of SARS-CoV-2 to pregnant women. (ii) The provision of safe, personalised and woman-centred care during pregnancy, birth and the early postnatal period, during the COVID-19 pandemic. (iii) The provision of safe, personalised and woman-centred care to pregnant and postnatal women with suspected/confirmed COVID-19. This is very much an evolving situation requiring this guidance

2020 Royal College of Obstetricians and Gynaecologists

12. Coronavirus (COVID-19) infection and pregnancy

with or for COVID-19. 15 Similar findings were reported in a large systematic review of 2,567 pregnancies with COVID-19, where 50.8% of women were from a BAME background. 38.2% of the women were obese and 32.5% had chronic comorbidities such as asthma and hypertension. 28 The association with BAME is particularly apparent and echoes previous findings that UK BAME pregnant women generally have worse outcomes in pregnancy and birth. 23 Furthermore, 13% of the UK’s total population identifies as being from a BAME (...) affects 5% of pregnant women in the UK, with the majority (88%) of women with diabetes in pregnancy affected by gestational diabetes. 39 In the UKOSS study, comorbidities such as diabetes were associated with pregnant women being admitted to hospital with COVID-19. 15 In non-pregnant individuals, a UK study of 20,133 patients admitted to high dependency and intensive care with COVID-19 found uncomplicated diabetes was one of the most common comorbidities (21%, 3650/17599); a further 7% (n=1299

2020 Royal College of Obstetricians and Gynaecologists

13. Coronavirus (COVID-19) infection and pregnancy

will not be able to give individual clinical advice or information for specific organisational requirements via this email address. Information for pregnant women and their families is available in question and answer format, with accompanying videos in some cases, on the RCOG COVID-19 hub. 8 1.1 The virus Novel coronavirus (SARS-CoV-2) is a new strain of coronavirus causing COVID-19, first identified in Wuhan City, China. Other human coronavirus (HCoV) infections include HCoV 229E, NL63, OC43 and HKU1, which (...) Coronavirus (COVID-19) infection and pregnancy 1 Information for healthcare professionals Version 9: Published Wednesday 13 May 2020 Coronavirus (COVID-19) Infection in Pregnancy2 Contents Summary of updates 3-5 1. Introduction 6-11 2. Advice for health professionals to share with pregnant women 12-19 3. Advice for all midwifery and obstetric services caring for pregnant women 20-36 4. Advice for services caring for women with suspected or confirmed COVID-19 37-39 Acknowledgements 40 Appendix 1

2020 Royal College of Obstetricians and Gynaecologists

14. Updated SOGC Committee Opinion – COVID-19 in Pregnancy

have specific questions that are beyond the scope of these guidelines and we encourage you to consult with local experts if possible, and look at national, regional and institutional resources for up-to-date information on testing and infection prevention protocols. March 13th 2020 In December 2019, a novel coronavirus, eventually termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in Wuhan, China. As of 10 March, 2020, COVID-19 has infected >100 000 people globally (...) on how to prevent or manage infection with COVID-19. Due to physiologic changes that occur in pregnancy, when compared with their non-pregnant counterparts, pregnant women with lower respiratory tract infections often experience worse outcomes, including higher rates of hospital and intensive care unit admission. (3) Since 2002 there have been two other global outbreaks of highly-pathogenic coronaviruses: severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS). While SARS

2020 Society of Obstetricians and Gynaecologists of Canada

15. Guidance for antenatal screening and ultrasound in pregnancy in the evolving coronavirus (COVID-19) pandemic

Guidance for antenatal screening and ultrasound in pregnancy in the evolving coronavirus (COVID-19) pandemic 1 Information for healthcare professionals Version 1: Published Monday 23 March 2020 Guidance for antenatal screening and ultrasound in pregnancy in the evolving coronavirus (COVID-19) pandemic2 Authors Matthew Jolly, NHS England & NHS Improvement Myles T aylor, BMFMS Jane Fisher, ARC Nadia Permalloo, PHE Annette McHugh, PHE Christoph Lees, Imperial College/ISUOG Pranav Pandya, UCLH/PHE (...) their appointment rescheduled due to COVID-19. If you have symptoms of COVID-19 you must not attend your appointment but phone your maternity service for advice. Maternity units may wish to provide additional information to pregnant women which includes the following: • Reason they are unable to have their appointment today for example: they have suspected Covid-19 7 or have been in contact with someone who has recently had the infection. • When they will have their appointment rescheduled. • How

2020 Royal College of Obstetricians and Gynaecologists

16. COVID 19 rapid evidence summary: Remdesivir for treating hospitalised patients with suspected or confirmed COVID-19

Discussion and limitations of the evidence Remdesivir has not been studied in the paediatric population or in pregnant women with COVID-19 and there are currently limited safety data. In addition, no data was found for the outcomes of disease complications, ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO 2 /FiO 2 ) and cost-effectiveness. The included studies compared remdesivir with placebo and no data are available for its effects compared with a different active comparator (...) COVID 19 rapid evidence summary: Remdesivir for treating hospitalised patients with suspected or confirmed COVID-19 COVID 19 rapid evidence summary: Remdesivir for treating hospitalised patients with suspected or confirmed COVID-19 Evidence summary Published: 5 June 2020 www.nice.org.uk/guidance/es27 pathways Key messages Key messages The content of this evidence review was up-to-date on 4 June 2020. See summaries of product characteristics (SPCs), British national formulary (BNF) or the MHRA

2020 National Institute for Health and Clinical Excellence - Advice

17. Rapid Review Update 1: Is there an increased risk of adverse maternal or fetal outcomes in women diagnosed with COVID-19 during pregnancy?

3, 2020 Akhtar, H., Patel, C., Abuelgasim, E., & Harky, A. (2020). COVID-19 (SARS- CoV-2) infection in pregnancy: A systematic review. Gynecologic and Obstetric Investigation. Epub ahead of print. Jul 30, 2020 (Search completed May 22, 2020) P: pregnant women and their fetuses/neonates E: COVID-19 infection C: no comparator O: maternal COVID-19 symptoms, pregnancy complications, neonatal COVID- 19 symptoms, neonatal health status, delivery timing and type, vertical transmission This review (...) includes 38 studies reporting on a total of 520 pregnant women in their third trimesters with COVID-19 infections. Most studies were from China, with other studies from Italy, Peru, India, USA, Portugal, South Korea. • 2 cohort studies • 11 cross- sectional studies • 4 case control studies • 11 case reports • 10 case series reports Birth outcomes were: • 433 newborns (366 cesarean deliveries) • Delivery outcomes for remaining pregnancies not reported In a meta-analysis of 3 studies, 60 pregnant women

2020 COVID-19 Rapid Evidence Service

18. Is there an increased risk of adverse maternal or fetal outcomes in women diagnosed with COVID-19 during pregnancy?

included 4 RT-PCR positive neonates, 2 stillbirths, and 1 neonatal death. No evidence of vertical transmission. Limited data suggest that pregnant women have a clinical presentation and severity similar to non- pregnant adults, and adverse maternal and perinatal outcomes were rare. Low Not reported Yang Z, Wang M, Zhu Z, & Liu Y. (2020). Coronavirus disease 2019 (COVID-19) and pregnancy: a systematic review J Matern Fetal Neonatal Med. Epub ahead of print. Apr 20, 2020 (Search to Mar 26, 2020 (...) . No direct evidence of intrauterine vertical transmission. Moderate Low Version 1: May 15, 2020 7 The clinical characteristics of pregnant women with COVID-19 are similar to those of non-pregnant adults. Fetal and neonatal outcomes appear good in most cases. Limitation: Available data only include pregnant women infected in their third trimesters. Della Gatta AN, Rizzo R, Pilu G, & Simonazzi G. (2020). COVID19 during pregnancy: a systematic review of reported cases Am J Obstet Gynecol. Epub ahead

2020 COVID-19 Rapid Evidence Service

19. Coronavirus (COVID-19) and Pregnancy: What Maternal-Fetal Medicine Subspecialists Need to Know

Respiratory Syndrome Coronavirus (MERS- CoV) infection during pregnancy: Report of two cases & review of the literature. J Microbiol Immunol Infect 2019 Jun;52(3):501-3. 6. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 2004 Jul;191(1):292-7. 7. Lei D, Wang C, Li C, Fang C, Yang W, Cheng B, et al. Clinical characteristics of pregnancy with the 2019 novel coronavirus disease (COVID-19) infection (...) - guidance.html). What is known about COVID-19 in pregnancy? Currently, there is limited information from published scientific reports about the susceptibility of pregnant women to COVID-19 and severity of infection. Available data are still limited to small case series. In general, pregnant women experience immunologic and physiologic changes that make them more susceptible to viral respiratory infections. The initial characterization of pregnant women as a high-risk group was based largely on this fact

2020 Society for Maternal-Fetal Medicine

20. Valproate Pregnancy Prevention Programme: temporary advice for management during coronavirus (COVID-19)

Valproate Pregnancy Prevention Programme: temporary advice for management during coronavirus (COVID-19) Valproate Pregnancy Prevention Programme: temporary advice for management during coronavirus (COVID-19) - GOV.UK Tell us whether you accept cookies We use about how you use GOV.UK. We use this information to make the website work as well as possible and improve government services. Accept all cookies You’ve accepted all cookies. You can at any time. Hide Search Guidance and support Valproate (...) Pregnancy Prevention Programme: temporary advice for management during coronavirus (COVID-19) Guidance has been published to support initiation of valproate in female patients and for annual review and pregnancy testing during the coronavirus pandemic. Published 21 May 2020 From: Therapeutic area: , Contents Temporary guidance for specialists Valproate is harmful if used in pregnancy. Children exposed to valproate in utero have a very high risk for congenital malformations (10% risk

2020 MHRA Drug Safety Update

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