Holistic Approach in Pregnant Women with COVID-19

Öz

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered species of corona virus. The first cases were seen in Wuhan, China, in December 2019. With the rapid spread of the corona virus outbreak, it has been declared an ‘Internationally Important Emergency Public Health Situation’ by the World Health Organization. Concerns about the pregnancy process are also increasing since the severe infectivity of the disease and that its effects on pregnancy is largely unknown. Pregnancy is a condition which the immune system is partially suppressed, and although current evidence shows that COVID-19 infection is less aggressive in pregnancy than the Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome virus, pregnant women should be considered as an unstable population that requires special care. In the pandemic process, the need for holistic care increases in supplying with the special care and needs of pregnant women. In COVID-19 disease, the care of pregnant women should be addressed with a holistic (holistic) approach as well as modern health care concepts. Holistic care method satisfies the special care of pregnant women and guides midwives and nurses. Holistic care during the entire epidemic process of pregnant women is important for improving the quality of care.

Anahtar Kelimeler

• covıd-19
• midwifery
• pregnancy
• holistic approach

COVID-19’lu veya COVID-19 Saptanan Gebelerde Holistik Yaklaşım

Öz

Koronavirüs hastalığı (COVID-19) yeni keşfedilen bir korona virüs türünün neden olduğu bir enfeksiyon hastalığıdır. İlk vakalar 2019’un Aralık ayında Çin’in Wuhan şehir merkezinde görülmüştür. Korona virüs salgının hızla yayılması ile Dünya Sağlık Örgütü tarafından ‘Uluslararası Öneme Sahip Acil Halk Sağlığı Durumu’ olarak ilan edilmiştir. Hastalığın ciddi enfektivitesi ve gebelik üzerine olan etkilerinin büyük ölçüde bilinmemesi nedeni ile gebelik süreci ile ilgili endişeler de artmaktadır. Gebelik immün sistemin kısmi olarak baskılandığı bir durumdur ve mevcut kanıtlar COVID-19 enfeksiyonunun gebelikte Şiddetli Akut Solunum Yolu Sendromu (SARS-CoV) ve Orta Doğu Solunum Sendromu’na (MERS-CoV) neden olan virüslere oranla daha az agresif seyrettiğini gösterse de gebeler özel bakım gerektiren, hastalığa karşı dayanıksız bir popülasyon olarak düşünülmelidir. Pandemi sürecinde gebelerin özel bakımının ve ihtiyaçlarının karşılanmasında, holistik bakıma olan ihtiyaç artmaktadır. COVID-19 hastalığında gebelerin bakımı, modern sağlık bakım kavramlarının yanı sıra holistik (bütünsel) bir yaklaşımla ele alınmalıdır. Gebelerin özel bakımının karşılanması ve hastalığın yönetiminde holistik bakım yöntemi ebelere ve hemşirelere rehberlik edebilir. Gebelerin tüm salgın sürecinde holistik bakım alması bakımın kalitesinin artması açısından önemlidir.

Anahtar Kelimeler

• covid-19
• ebelik
• gebelik
• holistik yaklaşım

Kaynakça

1. 1. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand 2020;99(7):823-829.
2. 2. Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, Iosifidis C, Agha R. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020; 76: 71-76.
3. 3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H , Guo L, Xie J , Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
4. 4. World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. Available from: https://covid19.who. int. Erişim tarihi: 10 Aralık 2020.
5. 5. Abdollahpour S, Khadivzadeh T. Improving the quality of care in pregnancy and childbirth with coronavirus (COVID-19): A systematic review. J Matern Fetal Neonatal Med 2020; 1-9.
6. 6. Liang H, Acharya G. Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow? Acta Obstet Gynecol Scand 2020; 99: 439-444.
7. 7. Englund JA, Chu HY. Respiratory virus infection during pregnancy: Does it matter? J Infect Dis 2018; 218: 512-515.
8. 8. Goodnight WH, Soper DE. Pneumonia in pregnancy. Crit Care Med 2005; 33:390-397.

9. 9. O’Day MP. Cardio-respiratory physiological adaptation of pregnancy. Semin Perinatol 1997; 21:268-275. 10. Nelson-Piercy C. Respiratory disease. In: Handbook of Obstetric Medicine. Boca Raton: CRC Press; 2015:371.
10. 11. van Well GTJ, Daalderop LA, Wolfs T, Kramer BW. Human perinatal immunity in physiological conditions and during infection. Mol Cell Pediatr 2017:4:4.
11. 12. Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, Louie J, Doyle TJ, Crockett M, Lynfield R, Moore Z, Wiedeman C, Anand M, Tabony L, Nielsen CF, Waller K, Page S, Thompson JM, Avery C, Springs CB, Jones T, Williams JL, Newsome K, Finelli L, Jamieson DJ, Pandemic H1N1 Influenza in Pregnancy Working Group. Pandemic 2009 Influenza A(H1N1) Virus Illness Among Pregnant Women in the United States. JAMA 2010;303(15):1517-1525.
12. 13. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, Ng PC, Lam PWY, Ho LC, To WWK, Lai ST, Yan WW, Tan PYH. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 2004; 191:292- 297.
13. 14. Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East respiratory syndrome coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature. J Microbiol Immunol Infect 2019; 52: 501-503.
14. 15. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J , Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet 2020;395:507-13.
15. 16. 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. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020;395:809-815.
16. 17. Zhu H, Wang L, Fang C, Peng S, Zhang L , Chang G, Xia S, Zhou W. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr 2020; 9:51-60.
17. 18. Zeng H, Xu C, Fan J, Tang Y, Deng Q , Zhang W, Long X. Antibodies in infants born to mothers with COVID-19 pneumonia. JAMA 2020;323(18):1848-1849.
18. 19. Knight M, Bunch K, Vousden N, et al. Characteristics and outcomes of pregnant women hospitalised with confirmed SARS-CoV-2 infection in the UK: A national cohort study using the UK Obstetric Surveillance System (UKOSS). Available from: https://www.npeu.ox.ac.uk. Erişim tarihi: 11 Mayıs 2020.
19. 20. Gatta AN, Rizzo R, Pilu G, Simonazzi G. Coronavirus disease 2019 during pregnancy: A systematic review of reported cases. Am J Obstet Gynecol 2020;223:36-41.
20. 21. Sarah K, Katz D, Hughes BL. Considerations for obstetric care during the COVID-19 pandemic. Am J Perinatol 2020; 37(8): 773-779.
21. 22. Papathanasiou I, Sklavou M, Kourkouta L. Holistic nursing care: Theories and perspectives. Am J Nurs Sci 2013;2(1): 1-5.
22. 23. Demirsoy N. Eski uygarlıklardan günümüze yansıyan holistik tıp uygulamaları. Türkiye Klinikleri J Med Ethics 2014;22(3):106- 119.
23. 24. Erickson HL. Philosophy and theory of holism. Nurs Clin North Am 2007; 42:139-63.
24. 25. Poon LC, Yang H, Lee JCS, Copel JA, Leung TY, Zhang Y, Chen D, Prefumo F. ISUOG interim guidance on 2019 novel coronavirus infection during pregnancy and puerperium: Information for healthcare professionals. Ultrasound Obstet Gynecol 2020; 55(5):700-708.
25. 26. Chen YH, Keller J, Wang IT, Lin CC, Lin HC. Pneumonia and pregnancy outcomes: A nationwide population-based study. Am J Obstet Gynecol 2012; 207:288.
26. 27. Yang H, Wang C, Poon LC. Novel coronavirus infection and pregnancy. Ultrasound Obstet Gynecol 2020;55(4):435‐437.
27. 28. Wang H, Zeng T, Wu X, Sun H. Holistic care for patients with severe coronavirus disease 2019: An expert consensus. Int J Nurs 2020; 55(3): 337-342.
28. 29. Centers for disease control and prevention. Coronavirus disease 2019 (COVID-19) situation summary. Available from: https ://www.cdc.gov, Erişim Tarihi: 20 Mayıs 2020.
29. 30. Ranganathan R, Khan AM, Chhabra P. Antenatal care, care at birth, and breastfeeding during the coronavirus (COVID-19) pandemic. Indian Journal of Community Health 2020;32(1):17- 20.
30. 31. Royal College of Obstetricians and Gynaecologists, 2020. Royal College of Midwives. Coronavirus (COVID-19) Infection in pregnancy. Information for healthcare professionals. Version 9. Published May 13 th. Available from: https://www.rcog.org. uk, Erişim tarihi: 15 Mayıs 2020.
31. 32. Kadın Sağlığı Hemşireleri ve Ebelere Yönelik Gebelik ve Doğum Sonrası Dönem COVID-19 Yönetimi. Kadın Sağlığı Hemşireliği Derneği. COVID-19 (SARS-Cov-2 Enfeksiyonu) Özel Bülteni, 7 Nisan 2020.
32. 33. Richens Y, Wilkinson M, Connor D. Guidance for the provision of antenatal services during the COVID-19 pandemic. Br J Midwifery 2020; 28(5): 324-327.
33. 34. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, Tao Q, Sun Z, Xia L. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology 2020; 296(2): 32-40.
34. 35. Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, Shi Z, Hu Z, Zhong W, Xiao G. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res 2020; 30: 269-271.
35. 36. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020;18(4):844‐847.
36. 37. Erez O, Mastrolia SA, Thachil J: Disseminated intravascular coagulation in pregnancy: Insights in pathophysiology, diagnosis and management. Am J Obstet Gynecol 2015; 213(4): 452-463.
37. 38. Lam CM, Wong SF, Leung TN, Chow KM, Yu WC, Wong TY, Lai ST, Ho LC. A case-controlled study comparing clinical course and outcomes of pregnant and non-pregnant women with severe acute respiratory syndrome. BJOG 2004; 111(8): 771-774.
38. 39. Bouaziz J, Even M, Isnard-Bogillot F, Vesale E, Nikpayam M, Mihalache A, et al. COVID-19 in pregnancy: What do we really know? [version 1;peer review: Awaiting peer review]. F1000Research, 2020;9(362):1-16.
39. 40. Eskici G. COVID-19 Pandemisi: Karantina için beslenme önerileri. Anadolu Kliniği Tıp Bilimleri Dergisi 2020; 25(1): 124- 129.
40. 41. Alder J, Fink N, Bitzer J, Hösli I, Holzgreve W. Depression and anxiety during pregnancy: A risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med 2007; 20(3): 189-209.
41. 42. Littleton HL, Breitkopf CR, Berenson AB. Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: A meta-analysis. Am J Obstet Gynecol 2007; 196(5): 424-432.
42. 43. Ng J, Sham A, Tang PL, et al. SARS: Pregnant women’ s fears and perceptions. Br J Midwifery 2004; 12(11): 698-702.
43. 44. The American Collage of Obstetricians and Gynaecologists. Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients. Availablefrom:https:// www.acog.org, Erişim tarihi: 17 Mayıs 2020.
44. 45. Hammond A, Foureur M, Homer CSE, Davis D. Space, place and the midwife: Exploring the relationship between the birth enviroment, neurobiology and midwifery practice. Women Birth 2013;26(4):277-81.
45. 46. The Lancet. Emerging understandings of 2019-nCoV. Lancet 2020; 395: 311.