Obstetrics and Gynecology Resources

Webinar Recordings
Presentation and Q&A

Handout

Q&A

Time Question
1:09:44, 1:12:59 for screening patients coming into the office are you using the cut off for fever 38 degrees or 37.5?
1:08:53, 1:11:11 When would you recommend ordering chest X-ray for pregnant women with mild symptoms? (You mentioned verbally that mild includes “normal cxr - if done”)
1:13:34 When you say mom and baby can stay together but… increased distance, do you mean mom distancing from baby or mom/baby dyad distancing from others? If it is the former, the lack of skin-to-skin contact between mom and baby could negatively impact breastfeeding success.
1:16:15 What is the role of midwifery for COVID positive cases? Does this account for a transfer of care to OB prenatally? and labour?
1:18:36 Breastfeeding the newborn - are we suggesting masking for all breastfeeding moms or just the ones that are COVID+, COVID-suspect or ILI ??
1:20:19 CPS released updated Practice Points on May 6. for Breasttfeeding and COVID-19+ and Suspected. Washing of breasts only if recently coughed on as an added precaution cleanse with soap and water.
1:22:19 Why no to Entonox ? due aerosol generation or any other reason.
1:23:18 Developmental Peds Question: Given social distancing may be the new normal for the forseeable future, how can we support healthy development for babies/toddlers who may be lacking social interaction (no baby groups, no in-person visits with other humans outside the bubble)?
1:26:17 Is there a sense from the speakers if these COVID related changes will be in place for 1 month, 3 months or 1 year?
1:28:45 Anecdotally hearing bookings decreased for routine childhood immunizations. Wondering if counselling at time of birth/discharge about importance of booking immunizations ? Other ways of trying to support

I am a manager in PH and our no show rate and late cancelation rate has dramatically increased
1:32:49 I’m finding that most women and partners are not using their mask well- ex. touching it constantly, moving it up and down, cutting a hole in it to have a smoke etc. Does AHS have a video that pregnant and PP women can watch (a few times!) that can do some teaching around this? If not would be very helpful if one could be made, (and translated to various languages, although I know this is hard…)

Handout for teaching patients how to wear a mask:https://www.albertahealthservices.ca//assets/info/ppih/if-ppih-covid-19-patients-masks.pdf
1:35:43 Can public health start doing weights again at vaccines? This way the family docs can do a virtual visit? It seems silly to have two in person visits at 2, 4, 6 months? - this is in Calgary
1:38:26 Can we determine concerns over wt/ht in 1-5 year olds without seeing them?
1:41:42 I have so many questions about how much extended family should be permitted to visit mom and new baby. You mentioned window visiting...for how long? How do you feel about visits if extended family have self isolated?
1:45:30 Who will be responsible for doing the daily phone check-ins for pregnant patients with COVID - her family doctor or her obstetrical provider?
1:50:19 Can anyone comment on the Kawasaki-like syndrome presentation in peds?
1:53:09 Similar to question re: Kawasaki type presentation in children - what atypical symptoms of COVID-19 have you seen in Pediatric patients?
1:59:23 Is EFW aware of the recommendation to delay the detailed anatomy scan to 21-22 weeks to decrease the need for repeat US due to anatomy not well seen? Are they rescheduling the appointments they prebooked or should we be advising families to call and reschedule.

Is there need for serial ultrasounds following Covid in pregnancy?
2:01:28 When should we refer to MFM COVID+ clinic? I work in High River and it is a bit of a drive for our patients to go to Calgary (but doable). If pt is asymptomatic or mildly symptomatic, can we continue to manage them (in appropriate setting/with full PPE, etc)?
RESOURCES

Cloth Masks to Help Slow the Spread of COVID-19

COVID Algorithm: Possible High Risk Pathway

Presentation and Q&A

Handout

Q&A

Time Question
36:17 How important is it to COMPLETELY segregate OB pts from CoVID patients-eg is it ok to house OB pts on the same physical floor, separated by a temporary partition with potential for airborne spread, possible use of same elevator for both, and possibly overlapping support staff?
37:51 Do you have any recommendations for pregnant health care workers, ie: working in ER covid vs. non covid patients; recommendation to go off in third trimester?
40:26 Rural doctors do the delivery and also neonatal rescuitation, which can be CPAP and AGMP. Should they be using N95 .AHS guidance is confusing
41:49 Assuming vertical transmission is not possible, what are the current recommendations on managing COVID discordant mother-baby patients postpartum?
42:55 Wash abdomen with what? Soap and water? or something stronger?
43:43 Are we recommending self-isolation for two weeks before booked sections?
44:44 What about repeat pap smear with ASCUS/LSIL etc? can we wait on those or should we repeat on time?
45:35 What is the recommendation for patients/couples who are interested in trying to get pregnant? Do you suggest waiting?
47:05 Should mom get a mask even if asymptomatic? Or only if symptoms? Are you only wearing full contact/droplet PPE for positive/probable COVID women in labour? And only masks if healthy?
48:54 Are the current COVID ideas/recommendations based on what we know about well-known respiratory illnesses and pregnancy (i.e. influenza and pregnancy)
50:08 Are we testing babes for COVID?
Comment (45:22) I believe the CFPC has published suggestions for prenatal schedule (altered schedule) @ https://www.cfp.ca/news/2020/03/25/3-24

Presentation and Q&A

Handouts

 

Resources

AHS COVID19 Podcast - Labour and Delivery with Dr. Colin Birch - https://www.youtube.com/watch?v=-QcfCqRO5-k