The modern organizational principles of specialized medical care for pregnant and puerperant women during the coronavirus pandemic in the Republic of Kazakhstan

Lokshin V.N., Sharman A.T., Mirzakhmetova D.D., Terlikbaeva A.T., Aimbetova A.R., Karibaeva Sh.K., Urazymbetova K.A.

1) PERSONA International Clinical Center for Reproductology, Almaty, Kazakhstan; 2) Academy of Preventive Medicine, Almaty, Kazakhstan; 3) Research Center of Obstetrics, Gynecology, and Perinatology, Almaty, Kazakhstan
The COVID-19 pandemic sweeping around the world has demanded the introduction of emergency lock-down measures, suspended the operation of enterprises, and led to the development of a systemic economic crisis. In a number of countries where governments have taken austerity preventive anti-epidemic measures, the situation could be controlled and a large number of viral infection victims could be prevented.
The obstetric service has always been an area of increased responsibility for the life and health of the mother and her child. Each country has operating algorithms, protocols, standards, and guidelines. However, during the epidemic, it can be dangerous to implement the entire package of measures and procedures in the context of COVID-19 infection due to the need to visit outpatient and inpatient healthcare facilities and laboratories. Algorithms for managing pregnancy and childbirth are of particular importance during a viral pandemic. The paper gives an algorithm for the management of pregnant, parturient, and puerperant women with COVID-19 in the Republic of Kazakhstan. The algorithm has been elaborated by the authors on the basis of the experience of the countries that previously faced a true pandemic (China, Italy, and Spain). Along with the traditionally existing orders and recommendations, this algorithm has been introduced in women’s clinics and obstetric hospitals of various regionalization levels in order to preventatively respond to an increase in the number of COVID-19 cases and carriers among pregnant parturient, and puerperant women. In the Republic of Kazakhstan, as of September 1, 2020 COVID-19 cases were registered in 4851 women, of whom there were 3473 pregnant women and 1378 postpartum ones. Spontaneous childbirth occurred in 1247 (90.5%) women; caesarean section was performed in 131 (9.5%) cases. COVID-19 was confirmed in 124 (8.75%) of the 1,420 newborns; of whom 1116 (78.57%) infants were born to puerperas with the confirmed diagnosis and 304 (21.43%) were born to mothers with a negative COVID-19 test.

Keywords

COVID-19
SARS-CoV-2
coronavirus infection
pregnant women

References

  1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497-506. https://dx.doi.org/10.1016/S0140-6736(20)30183-5.
  2. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223): 507-13. https://dx.doi.org/10.1016/S0140-6736(20)30211-7.
  3. Liu Y., Gayle A.A., Wilder-Smith A., Rocklöv J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J. Travel Med. 2020; 27(2): taaa021. https://dx.doi.org/10.1093/jtm/taaa021.
  4. Hoffmann M., Kleine-Weber H., Krüger N., Müller M., Drosten C., Pöhlmann S. The novel coronavirus 2019 (2019-nCoV) uses the SARS-coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells. bioRxiv. 2020: 2020.01.31. 929042. https://dx.doi.org/10.1101/2020.01.31.929042. Available at: https://www.biorxiv.org/content/10.1101/2020.01.31.929042v1
  5. World Health Organization. Critical preparedness, readiness and responsactions for COVID-19. Interim guidance. 7 March 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/20200307-cccc-guidance-table-covid-19-final pdf?sfvrsn=1c8ee193_10
  6. Drews F.A., Mulvey D., Stratford K., Samore M.H., Mayer J. Evaluation of a redesigned personal protective equipment gown. Clin. Infect. Dis. 2019; 69(Suppl. 3): S199-205. https://dx.doi.org/10.1093/cid/ciz520.
  7. Fineberg H.V. Ten weeks to crush the curve. N. Engl. J. Med. 2020; 382(17): e37. https://dx.doi.org/10.1056/NEJMe2007263.
  8. Cohen J., Vignaux O., Jacquemard F. Covid-19 in pregnant women: general data from a French National Survey. Eur. J. Obstet. Gynecol. Reprod. Biol. 2020; 251: 267-8. https://dx.doi.org/10.1016/j.ejogrb.2020.06.002.
  9. Kampf G., Todt D., Pfaender S., Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J. Hosp. Infect. 2020; 104(3): 246-51. https://dx.doi.org/10.1016/j. jhin.2020.01.022.
  10. Chen L., Li Q., Zheng D., Jiang H., Wei Y., Zou L. et al. Clinical characteristics of pregnant women with Covid-19 in Wuhan, China. N. Engl. J. Med. 2020; 382(25): e100. https://dx.doi.org/10.1056/NEJMc2009226.
  11. Liu D., Li L., Wu X., Zheng D., Wang J., Yang L. et al. Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) pneumonia: a preliminary analysis. AJR Am. J. Roentgenol. 2020; 215(1): 127-32. https://dx.doi.org/10.2214/AJR.20.23072.
  12. World Health Organization, 2020. CC BY-NC-SA 3.0 IGO. Available at: https://www.euro.who.int/__data/assets/pdf_file/0009/439749/breastfeeding-COVID-19-rus.pdf
  13. Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)», версия 3 (3 марта 2020г.) (утвержденные Министерством здравоохранения РФ). [Temporary guidelines "Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)", version 3 (03.03.2020), approved. Ministry of Health of Russia]. Available at: http://www.consultant.ru/document/cons_doc_LAW_347896/
  14. Accelerated emergency use authorization (EUA) Summary. SARS-cov-2 ASSAY Apr 20, 2020. Available at: https://www.fda.gov/media/136875/download https://novayagazeta.ru/articles/2020/03/25/84505-kakoy-covid-otkryvaetsya-iz-nashego-okna
  15. Van Doremalen N., Bushmaker T., Morris D.H., Holbrook M.G., Gamble A., Williamson B.N. et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N. Engl. J. Med. 2020; 382(16): 1564-7. https://dx.doi.org/10.1056/NEJMc2004973.
  16. Mackay I.M., Arden K.E. MERS coronavirus: diagnostics, epidemiology and transmission. Virol. J. 2015; 12: 222. https://dx.doi.org/10.1186/s12985-015-0439-5.
  17. Lazzerini M., Putoto G. COVID-19 in Italy: momentous decisions and many uncertainties. Lancet Glob. Health. 2020; 8(5): e641-2. https://dx.doi.org/10.1016/S2214-109X(20)30110-8.

Received 03.09.2020

Accepted 22.09.2020

About the Authors

Vyacheslav N. Lokshin, MD, professor, academician of the National Academy of Sciences of the Republic of Kazakhstan, president of the Kazakhstan Association of Reproductive Medicine; Director General of the International Clinical Center for Reproductology PERSONA.
Tel.: +7(727)382-77-77. E-mail: v_lokshin@persona-ivf.kz. ORCID: 0000-0002-4792-53807 050060. Kazakhstan, Almaty, Utepova str., 32A.
Almaz T. Sharman, MD, professor, President of the Academy of Preventive Medicine of the Republic of Kazakhstan.
E-mail: asharman@zdrav.kz. ORCID: 0000-0003-3977-3636. Kazakhstan, 050008, Almaty, Klochkova str., 66, office 601.
Dinara D. Mirzakhmetova, obstetrician-gynecologist of the highest category;
Chairman of the Board, Scientific Center for Obstetrics, Gynecology and Perinatology.
Tel.: +7(727)300-45-80. E-mail: d.mirzakhmetova@mail.ru. ORCID: 0000-0002-6329-5999. Kazakhstan, Almaty, Dostyk Ave., 125.
Aigul T. Terlikbaeva, candidate of medical sciences, PhD, obstetrician-gynecologist of the highest category, Deputy for Science and Strategy, Scientific Center for Obstetrics, Gynecology and Perinatology. Tel.: +7(727)300-45-05. E-mail: aigultrk@mail.ru. ORCID: 0000-0002-1777-805.
Kazakhstan, Almaty, Dostyk Ave., 125.
Aliya R. Aimbetova, MD, obstetrician-gynecologist of the highest category, Deputy for Clinical Activities, Scientific Center for Obstetrics, Gynecology and Perinatology.
Tel.: +7(727)300-46-03. E-mail: aaimbetova@inbox.ru. ORCID: 0000-0001-9809-2019. Kazakhstan, Almaty, Dostyk Ave., 125.
Sholpan K. Karibaeva, PhD, obstetrician-gynecologist, reproductologist of the highest category, strategic development director of the International Clinical Center for Reproductology PERSONA. Tel.: +7(727)382-77-77. E-mail: sh.karibaeva@gmail.com. ORCID: my-orcid7 050060. Kazakhstan, Almaty, Utepova str., 32A.
Kymbat A. Urazymbetova, obstetrician-gynecologist, reproductologist of the International Clinical Center for Reproductology PERSONA.
Tel.: +7(727)382-77-77. E-mail: dr.urazymbetova@gmal.com. ORCID: 0000-0002-1636-1172. Kazakhstan, Almaty, Utepova str., 32A.

For citation: Lokshin V.N., Sharman A.T., Mirzakhmetova D.D., Terlikbaeva A.T., Aimbetova A.R., Karibaeva Sh.K., Urazymbetova K.A. The modern organizational principles of specialized medical care for pregnant and puerperant women during the coronavirus pandemic in the Republic of Kazakhstan.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 12: 34-43 (in Russian)
https://dx.doi.org/10.18565/aig.2020.12.34-43

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