[CG] Guideline for obstetric patients presenting with non- obstetric symptoms, with specific reference to COVID-19

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In order to ensure that pregnant and postnatal women who are being managed in non-obstetric settings in relation to respiratory symptoms have appropriate obstetric input, a robust communication pathway must be in place.  This needs to include the following:

The on-call Obstetric team must be notified of all pregnant and post-natal women who are admitted to non-obstetric wards.

The ID details of pregnant and post-natal women (inc COVID-19) admitted to non-obstetric wards need to be listed on a “red flag obstetric outliers board” in Labour Ward.

The “red flag obstetric outliers board” must be kept up to date and discussed by obstetric medical staff at twice daily handovers.

All obstetric patients with respiratory symptoms in non-obstetric wards need a daily review by a senior obstetrician – this could be by phone call with a senior physician depending on gestation and clinical condition.

All phone discussions must be recorded in BadgerNet.

Obstetric patients in ITU need twice daily consultant-to-consultant discussion and a minimum of daily ward review (depending on gestation).

The requirement for and frequency of CTGs will be gestation directed and will be dependent on the clinical scenario.  This should be reviewed on a regular basis and agreed by the on-call obstetric consultant.

There is no need for routine CTG monitoring for pregnant women with respiratory symptoms in non-obstetric wards.

The on-call Obstetric team must to be notified of all pregnant and postnatal patients being discharged from a non-obstetric ward prior to the point of discharge.  This will allow the obstetric team to ensure that the patient has an appropriate antenatal / postnatal follow-up plan in place, and arrange an antenatal check-up prior to leaving the hospital for women over 12 weeks gestation.

 

FOR ALL OBSTETRIC WOMEN IN NON-OBSTETRIC WARDS, PLEASE REMEMBER:

COMMUNICATION

SENIOR MULTI-DISCIPLINARY DISCUSSION

DIFFERENTIAL DIAGNOSES OF BREATHLESSNESS / COUGH / PYREXIA in pregnancy.  Not all women will have COVID-19.

Last reviewed: 24 March 2020

Next review: 21 September 2022

Approved By: GONEC