Navigating Pregnancy in COVID pandemic a big challenge

“COVID TIMES-ONE YEAR’S LESSONS FOR OBS & GYN”

An eminent academician, ace speaker Dr. Reena J Wani, Prof & Unit Head, HBT Medical College, Dr. R N Cooper Hospital, Mumbai through webinar shared her experiences of “One Year lessons for Obst & Gyn amidst pandemic” to the members of Belgaum Obst & Gyns (BLOGS).

Pregnancy is an important phase in women which is full of excitement and anticipation for family members. But for many expectant mothers, the COVID-19 pandemic has this time badly hit with fear, anxiety and uncertainty. Mumbai has emerged as hot spot of Covid-19. It has done huge damage to economy & disaster to health care facilities. It is a big challenge for Obstetricians to manage pregnant women amidst pandemic opined Dr. Reena. In her presentation she highlighted that, Mumbai, Pune & Nashik has crossed covid peaks.

Changes in Practice: She shared her institutions practice of following tele consultation, phone consultation, WhatsApp calls, tele medicines to reduce ANC visits to hospitals. Only those with complications were called for face-to-face consultations to hospital with COVID appropriate behaviors. As per ICMR guidelines before admission all the women were examined by RT-PCR. Rational use of N95 & PPE kits was used wherever required in treating patients. Hand hygiene, use of mask, social distancing during OPD and ward rounds were strictly adhered. Nurses & Security guards were educated on importance of covering nose with mask and later they passed on this information to all patients and their attenders. Unfortunately, 2021 has brought horrific 2nd wave. She shared simple initiatives like use of face shield, foot safety, proper care is important during procedures.

pregnant woman holding baby s shoes
Photo by Andre Furtado on Pexels.com

All along her presentation Dr. Reena highlighted that newer finding new ways of working, based on useful, applicable evidence and we disseminated good practices from class IV workers to nursing staff, interns and PGS. We routinely conducted departmental meetings to face the challenge posed by COVID and maintained strict vigil and educated staff to provide safe, high quality care for women and families during the COVID-19 era. Symptomatic & suspected women were delivered in a separate isolation room. For suspected cases needing surgery separate OT was designated.

Isolation ward for asymptomatic patients. Neonatologist & Anesthetist were part of the team and regular meeting and communication lines were established to avoid confusions.

Three ‘T’mantra: She stressed for Test, Triage and Treat. Dr. Reena presented with statistical evidence of how her hospital contained COVID infection among maternity patients. Sizeable number of COVID patients underwent cesarean section with all standard protocols in place. Fortunately, vertical passing of the infection is not noticed in any of the cases. With appropriate precautions breastfeeding was advised.

Dr. Reena Wani dispassionately & eloquently put forward at length on medication in pregnancy and cautioned the medications to be decided on case-to-case basis and advised to take opinion of physicians before administering drugs. Timing of the drug interventions is paramount she added. She strongly advocated for radical use of drugs based on scientific evidences. Judicious use of steroids and till today the treatment modalities are evolving and sometimes essential medicines are not available due to short supply. She stressed that there is no magic bullet drug for covid but quickly added healthy immune system is the best defense.

Various studies shows that Covid+ve may need cesarean section. Prone position is good but difficult for the women to adjust to this new position.

She also touched upon vaccines & vaccine efficacy. She called on the citizens to get vaccinated which is safe and very useful to shield against covid. Second wave is more dangerous take care and make difference. Indian medical community is very strong, knowledgeable and skillful and she was optimist & said that our doctors have done extremely well in trying circumstances.

Dr. Reena in her concluding remarks highlighted that coronavirus pandemic has a significant potential for creating anxiety, adversity and fear, which has a negative emotional effect on pregnant people. She advised the Obstetricians to take time out of their busy practice to provide awareness for family members, nurses not only about the physical health of pregnant women, but also their mental health. She advised the participants counselling can go a long way to keep the mental balance of women.

She attended to questions of participants which was moderated by Dr. Rajeshwari Patil, BLOGS Treasurer, Dr. Satish Dhamankar, BLOGS President introduced the guests and coordinated and Dr. Hema Patil, Secretary BLOGS proposed vote of thanks. Large number of participants attended the webinar which is appreciated by all delegates.

She advocated multidisciplinary team approach. Pulse oximeter has shot into prominence.

Dr. Satish Dhamankar introduced the speaker.

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