COVID-19 Pandemisinde Gebelik Dönemi ve Tele-Sağlık

Yıl 2020, Cilt: 36 Sayı: 3, 189 - 198, 28.12.2020

Tuba Kızılkaya , Selma Hancıoğlu Aytaç , Saadet Yazıcı

Öz

İlk kez Aralık 2019’da Çin’in Wuhan şehrinde pnömoni vakaları ile ortaya çıkan Koronavirüs-19 hastalığı (COVID-19) tüm dünyaya hızla yayılmış ve Dünya Sağlık Örgütü tarafından pandemi olarak ilan edilmiştir. Gebelerin immün sistemindeki değişiklikler nedeniyle enfeksiyona daha yatkın hale gelmeleri, COVID-19’un önlenmesi ve tedavisi açısından daha hassas yaklaşılmasını gerekli kılmaktadır. Pandemi nedeniyle hastaneye başvurmak istemeyen gebeler olabileceğinden, sağlık bakım hizmetlerinin aksamaması ve hastaneye başvurunun azaltılması için tele-sağlık, gözden geçirilmesi ve tüm kadınların erişebileceği şekilde sistematik uygulamaya aktarılması gereken önemli bir seçenektir. Bu derlemede; gebelik sürecinde COVID-19’un epidemiyolojisi, tanılanması, anne ve bebek açısından riskleri, alınması gereken önlemler, tedavisi, ebelik / hemşirelik bakımı ve tele-sağlığın pandemi sürecindeki önemi ele alınmıştır.

Anahtar Kelimeler

COVID-19, gebelik, tele-sağlık

Perinatal Period and Tele-Health in COVID-19 Pandemic (In the Light of Lessons Learned from SARS-CoV and MERS-CoV Infections)

Öz

Coronavirus-19 disease (COVID-19), which has first appeared with cases of pneumonia in Wuhan, China in December 2019. It has spread rapidly all over the world and has been declared as a pandemic by the World Health Organization. The fact that pregnant women are more vulnerable to viral infection due to changes in their immune system, there is a need more sensitive approach to prevention and treatment of COVID-19. Since there may be pregnant women who do not want to apply to the hospital due to a pandemic, tele health is an important option that should be consider and put into practice systematically so that all women can access it to prevent disruption of healthcare services and hospital admissions. In this review, epidemiology of COVID-19 during pregnancy, risks in terms of mother and baby, precautions to be taken, treatment, midwifery/nursing care and the importance of tele-health in the pandemic process are discussed.

Anahtar Kelimeler

COVID-19, pregnancy, tele-health

Kaynakça

• Alserehi, H., Wali, G., Alshukairi, A., Alraddadi, B. (2016). Impact of Middle East respiratory syndrome coronavirus (MERSCoV) on pregnancy and perinatal outcome. BMC Infect Dis;16:105. http://dx.doi.org/10.1186/s12879-016-1437-y.
• Breslin, N., Baptiste, C., Gyamfi-Bannerman, C., Miller, R., Martinez, R., Bernstein, K., ... & Fuchs, K. (2020). COVID-19 infection among asymptomatic and symptomatic pregnant women: Two weeks of confirmed presentations to an affiliated pair of New York City hospitals. AJOG MFM; 100118.
• Chen, H., Guo, J., Wang, C., Luo, F., Yu, X., Zhang, W., Li, J., Zhao, D., Xu, D., Gong, Q., Liao, J., Yang, H., Hou, W., & Zhang, Y. (2020). Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet, 395(10226), 809-815.
• Cho, S.Y., Kang, J.M., Ha, Y.E., Park, G.E., Lee, J.Y., Ko, J.H., Lee, J.Y., Kim, J.M., Kang, C.I., Jo, I.J., et al. (2016). MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study. The Lancet; 388(10048), 994-1001.
• Donnelly, C.A., Ghani, A.C., Leung, G.M., Hedley, A. J., Fraser, C., Riley, S., ... & Chan, K. P. (2003). Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. The Lancet;361(9371), 1761-1766. http://image.thelancet.com/ extras/03art4453 web.pdf
• Fang, L., Karakiulakis, G., & Roth, M. (2020). Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?. Lancet Respir Med;Apr; 8(4): e21.
• Halk Sağlığı COVID-19 Rehberi. T.C Sağlık bakanlığı Halk Sağlığı Genel Müdürlüğü COVID-19 (SARS-CoV2 Enfeksiyonu) Rehberi (Bilim Kurulu Çalışması) T.C. Sağlık Bakanlığı 11 Mart 2020. https://www.sanko.edu.tr/wp-content/uploads/2020/03/COVID-19_RehberiV5-25Subat2020-1.pdf (Erişim tarihi: 7 Mayıs 2020).
• Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., ... & Du, B. China Medical Treatment Expert Group for COVID-19,(2020) Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med; 10.
• Horne, J. R., & Vohl, M. C. (2020). Biological plausibility for interactions between dietary fat, resveratrol, ACE2 and SARS-CoV illness severity. Am J Physıol-Endoc M; https://doi.org/10.1152/ajpendo.00150.2020
• Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X. (2020). Wuhan, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet; 395(10223), 497-506.
• Hui, D.,S. (2017). Epidemic and Emerging Coronaviruses (Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome). Clin Chest Med; 38(1):71-86. doi: 10.1016/j.ccm.2016.11.007.
• Jiao, J. (2020). Under the epidemic situation of COVID‐19, should special attention to pregnant women be given?. J Med Virol; doi: 10.1002/jmv.25771.
• Karami, P., Naghavi, M., Feyzi, A., et al. (2020). Mortality of a pregnant patient diagnosed with COVID-19: A case report with clinical, radiological, and histopathological findings. Travel Med Infect Dis; 101665. doi: https://doi.org/10.1016/j.tmaid.2020.101665.
• Lam, C.M., Wong, S.F, Leung, T.N., Chow, K.M., Yu, W.C., Wong, T.Y., Lai, S.T., Ho, L.C. (2004). A case-controlled study comparing clinical course and outcomes of pregnant and non-pregnant women with severe acute respiratory syndrome. BJOG; 111, 771-774.
• Letko, M., Marzi, A., & Munster, V. (2020). Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses. Nature Microbiology, 5(4), 562-569.
• Liang, T. (ed.) Handbook of COVID-19 Prevention and Treatment. https://video-intl.alicdn.com/Handbook%20of%20COVID-19%20Prevention%20and%20Treatment%20%28Standard%29.pdf?spm=a3c0i.14138300.8102420620.download.110f647f78nQom&file=Handbook%20of%20COVID-19%20Prevention%20and%20Treatment%20%28Standard%29.pdf (Erişim: 7 Mayıs 2020).
• Li, D., Jin, M., Bao, P., Zhao, W., Zhang, S. (2020). Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019. JAMA Network Open; 3(5):e208292. doi:10.1001/jamanetworkopen.2020.8292
• Lin, S.C., Ho, C.T., Chuo, W.H., Li,S., Wang, T.T., Lin, C.C. (2017). Effective inhibition of MERS‐CoV infection by resveratrol. BMC Infect Dis; 17:144. https://doi.org/10.1186/s12879‐017‐2253‐8.
• Liu D, Li L, Wu X, et al. (2020). Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. AJR Am. J. Roentgenol; 1-6. doi: 10.2214/AJR.20.23072.
• Malik, A., El Masry, K.M., Ravi, M., Sayed, F. (2013). Middle East Respiratory Syndrome Coronavirus during Pregnancy, Abu Dhabi, United Arab Emirates. Emerg Infect Dis; 2016;22:515-7. http://dx.doi.org/10.3201/eid2203.151049.
• Maxwell, C., McGeer, A., Tai, K. F. Y., Sermer, M. (2017). No. 225-Şiddetli akut solunum yolu sendromu (SARS) şüphesi olan veya muhtemel annelerden doğan obstetrik hastalar ve yenidoğanlar için yönetim kılavuzları. J. Obstet. Gynaecol; 39 , e130 – e137.
• Mertz, D., Geraci, J., Winkup, J., Gessner, B. D., Ortiz, J. R., & Loeb, M. (2017). Pregnancy as a risk factor for severe outcomes from influenza virus infection: a systematic review and meta-analysis of observational studies. Vaccine; 35(4), 521-528.
• Payne, D.C., Iblan, I., Alqasrawi, S., et al. (2014). Stillbirth during infection with Middle East respiratory syndrome coronavirus. J Infect Dis; 209:1870-2. http://dx.doi.org/10.1093/infdis/jiu068.
• Peretz J, Pekosz A, Lane AP, Klein SL. (2016). Estrogenic compounds reduce influenza A virus replication in primary human nasal epithelial cells derived from female, but not male, donors. Am J Physiol Lung Cell Mol Physiol;310:L415‐L425. https://doi.org/10.1152/ajplung.00398.2015.
• Racicot, K., & Mor, G. (2017). Risks associated with viral infections during pregnancy. J Clin Invest, 127(5), 1591-1599.
• RCOG. (2020). Coronavirus (COVID-19) Infection in Pregnancy. Information for healthcare professionals Version 8: Published Friday 17 April 2020 https://www.rcog.org.uk/globalassets/documents/guidelines/2020-04-17-coronavirus-covid-19-infection-in-pregnancy.pdf (Erişim tarihi: 7 Mayıs 2020).
• Santos, L. F., Borges, R. F., & Zocche, D. (2019). Telehealth and Breastfeeding: An Integrative Review. Telemedicine and e-Health; doi: 10.1089/tmj.2019.0073
• Schumacher, A. (2017). Human chorionic gonadotropin as a pivotal endocrine immune regulator initiating and preserving fetal tolerance. Int J Mol Sci;18(10):2166.
• Schwartz, D. A. (2020). An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Archives of Pathology & Laboratory Medicine. doi: 10.5858/arpa.2020-0901-sa
• Schwartz, D. A., & Graham, A. L. (2020). Potential Maternal and Infant Outcomes from Coronavirus 2019-nCoV (SARS-CoV-2) Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections. Viruses; 12(2), 194. doi: 10.3390/v12020194
• Spiby, H., Faucher, M. A., Sands, G., Roberts, J., & Kennedy, H. P. (2019). A qualitative study of midwives’ perceptions on using video‐calling in early labor. Birth, 46(1), 105-112.
• T.C. Sağlık Bakanlığı. 2019-nCoV Hastalığı Sağlık Çalışanları Rehberi (Bilim Kurulu Çalışması) T.C. 24 OCAK 2020 Nisan https://hsgm.saglik.gov.tr/depo/haberler/ncov/2019nCov_Hastal_Salk_alanlar_Rehberi.pdf (Erişim tarihi: 7 Mayıs 2020).
• TMFTP - Türkiye Maternal Fetal Tıp ve Perinatoloji Derneği. (2020). Gebelikte Coronavirüs Enfeksiyonu (COVID-19) Hakkında Görüş (3. Bilgilendirme,03.04.2020) http://www.tmftp.org/files/Duyurular/TMFTP%20COVID19-3.pdf (Erişim tarihi: 7 Mayıs 2020).
• Türk Neonatoloji Derneği, (2020). Gebelik, Doğum ve Lohusalık döneminde “Yeni Koronavirüs Enfeksiyonu 2019”(COVID-19) Hakkında Türk Perinatoloji Derneği Görüşü. https://www.neonatology.org.tr/storage/2020/04/Untitled-attachment-00052.pdf (Erişim tarihi: 7 Mayıs 2020).
• Webster, P. (2020). Virtual health care in the era of COVID-19. The Lancet; 395(10231), 1180-1181.
• WHO, (2003). Acute respiratory syndrome China, Hong Kong Special Administrative Region of China, and Vietnam WER 2003; 78: 73-74. https://www.who.int/csr/don/2003_03_12/en/ (Erişim tarihi: 7 Mayıs 2020).
• WHO, (2014). Middle East respiratory syndrome coronavirus (MERS-CoV) – Turkey , Disease outbreak news WHO, https://www.who.int/csr/don/24-october-2014-mers/en/24October 2014. (Erişim tarihi: 7 Mayıs 2020).WHO, 2019a, What is Middle East respiratory syndrome (MERS) ? Middle East respiratory syndrome coronavirus (MERS-CoV) 20 December 2019 | Q&A https://www.who.int/news-room/q-a-detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov) (Erişim tarihi: 7 Mayıs 2020).
• WHO, (2019b). Middle East respiratory syndrome coronavirus (MERS-CoV) 20 December 2019 | Q&AWhat are the symptoms of MERS? How severe is it? https://www.who.int/news-room/q-a-detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov) (Erişim tarihi: 7 Mayıs 2020).
• WHO, (2019c), Middle East respiratory syndrome coronavirus (MERS-CoV) 20 December 2019 Q&AWhere have cases of MERS been identified? https://www.who.int/news-room/q-adetail/middle-east-respiratory-syndrome-coronavirus-(mers-cov) (Erişim tarihi: 7 Mayıs 2020).
• WHO, (2020a). Pneumonia of unknown cause reported to WHO China Office. https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/ (Erişim tarihi: 7 Mayıs 2020).
• WHO (2020b). Q-A-On-Covid-19-Pregnancy-Childbirth-And-Breastfeeding. https://www.who.int/news-room/q-a-detail/q-a-on-covid-19-pregnancy-childbirth-and-breastfeeding (Erişim tarihi: 7 Mayıs 2020).
• WHO (2020c). Coronavirus disease 2019 (COVID-19) Situation Report – 109. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200508covid-19-sitrep-109.pdf?sfvrsn=68f2c632_6 (Erişim tarihi: 9 Mayıs 2020).
• WHO (2020d). Rolling updates on coronavirus disease (COVID-19). 25 Ocak 2020 Launch of free online introductory course on the novel coronavirus. . https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (Erişim tarihi: 7 Mayıs 2020).
• WHO (2020e). WHO 2020, Rolling updates on coronavirus disease (COVID-19). 22 February 2020 ‘’11 000 African health care workers have been trained on COVID-19’’ https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (Erişim tarihi: 7 Mayıs 2020).
• WHO (2020f). Rolling updates on coronavirus disease (COVID-19). 5 March 2020 ‘’Launch of Be Ready campaign’’. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (Erişim tarihi: 7 Mayıs 2020).
• WHO (2020f). Rolling updates on coronavirus disease (COVID-19. 8-9 Nisan 2020 Ad-hoc consultation on managing the COVID-19 infodemic https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (Erişim tarihi: 7 Mayıs 2020).
• WHO (2020g). Rolling updates on coronavirus disease (COVID-19). More than 320 000 learners enrol in online COVID-19 courses https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (Erişim tarihi: 7 Mayıs 2020).
• WHO (2020h.) Rolling updates on coronavirus disease (COVID-19). 20 Mart 2020 WHO Health Alert for coronavirus launches on WhatsApp https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (Erişim tarihi: 7 Mayıs 2020).
• WHO (2020i). Rolling updates on coronavirus disease (COVID-19. 27 Mart 2020 WHO WhatsApp health alert launches in Arabic, French and Spanish https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (Erişim tarihi: 7 Mayıs 2020).
• Wilson, A. N., Ravaldi, C., Scoullar, M. J., Vogel, J. P., Szabo, R. A., Fisher, J. R., & Homer, C. S. (2020). Caring for the carers: Ensuring the provision of quality maternity care during a global pandemic. Women and Birth; doi: 10.1016/j.wombi.2020.03.011
• Yadav, S., Rawal, G., Baxi, M. (2016). An Overview of the latest infectious diseases around the world. J. Comm. Health Manag; 3, 41–43.
• Zaki, A.M., van Boheemen, S., Bestebroer, T.M. (2012). Suudi Arabistan'da zatürree olan bir erkekten yeni bir koronavirüs izolasyonu. N Engl J Med; 367 : 1814-1820.
• Zhang, L., Liu, Y. (2020). Potential interventions for novel coronavirus in China: A systematic review. J Med Virol; 92:479–490. https://doi.org/10.1002/jmv.25707.
• Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang, B., Shi, W., Lu, R. (2020). A new coronavirus from patients with pneumonia in China, 2019. N. Engl. J. Med; 382(8), 727-733.
• Zu, Z. Y., Jiang, M. D., Xu, P. P., Chen, W., Ni, Q. Q., Lu, G. M., & Zhang, L. J. (2020). Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology; 200490.