Author constructions: Drs Aifen Wang and Weidong Hu contributed
to this article equally. Conceptualization, Aifen Wang and Weidong Hu; Methodology, Aifen Wang
and Youguo Chen; Investigation, Aifen Wang; Writing – Original Draft,
Aifen Wang, Weidong Hu, Jinsong Yang and Huiping Guo; Writing – Review
& Editing, Aifen Wang, Jinsong Yang and Ziyue Zhang; Supervision, Aifen
Wang and Youguo Chen.
Disclosure statement: All authors declared no competing
interests.
SARS-CoV-2 was first noted in December 2019 in Wuhan, Hubei, China. The
World Health Organization reported that more than 1,699,595 people had
contracted COVID-19 and 106,138 people had died of SARS-CoV-2 on 12
April 2020. Men are more likely to contract COVID-19 than
women.1-4 Limited evidence is available to identify
whether pregnant women are susceptible to contracting COVID-19. However,
in Soochow city, Jiangsu, where 10,625,700 residents live, the first
patient with COVID-19 was confirmed on January 22, 2020. Between January
1 and March 31, 2020, 87 persons were confirmed as the COVID-19
infection. No new cases have been reported since February 18, 2020. All
patients with COVID-19 were discharged on 10 March 2020. There was a
total of 23493 pregnant women who did not contract COVID-19 and
delivered their babies in hospitals, except for one pregnant woman who
delivered by cesarean section in Soochow Fifth Hospital Affiliated to
Soochow University, which is a designated hospital for
COVID-195. In this report, we present our experience
of the protection of pregnant women in an epidemic area.
In Soochow, Jiangsu, all hospitals have developed detailed guidelines
for protecting pregnant women since January 22, 2020. We have protective
actions for pregnant women who had traveled from outside of Soochow city
(algolithm1) and pregnant women suspected of COVID-19 infection
(algolithm2). We take different levels of protective actions based on
the status of patients. The first level of protective action are staff
who wear surgical caps, surgical face masks, disposable coveralls and
surgical gloves; the second level are staff who wear surgical caps,
protective goggles, N95 face masks, disposable coveralls, surgical
gloves, and shoe covers; and the third level of protective action are
staff who wear surgical caps, face shields, N95 face masks, disposable
coveralls, surgical gloves, and shoe covers. In Soochow city, everyone
is obligated to apply for Health Code, which is two-dimensional barcodes
based on travel history and possible signs of COVID-19, such as fever,
dry cough, chest stress, and dyspnea, which were confirmed by physicians
since February 22, 2020. The three codes are red code, yellow code, and
green code. Red code is given to people who have traveled from a severe
epidemic area or have not terminated the quarantine phase. Yellow code
means people who live with someone who is in a quarantine room and has
dry cough, fever and dyspnea. Green code is meant for people with no
signs of COVID-19. People with red code have to be in the hospital or
stay in a quarantine room for 14 days. People with yellow code should be
in a quarantine room for seven days. People with red code or yellow code
are suggested against being in public areas. All people are obligated to
have Health Code and are involved in credit management. For those who
need to stay in the hospital, all people, including patients and staff,
are mandated to put on a face mask, whether symptomatic or not. At the
entrance of the hospital and each ward, temperature monitoring is
required for everyone, even staff. Only single rooms are provided for
one patient and one visitor in the obstetrical ward. In the designated
hospital, “fever clinic” is extremely effective in excluding patients
suspected of COVID-19. When pregnant patients have fever, they will be
consulted by physicians from the “fever clinic” as soon as possible.
These patients will receive RT-PCR and immunoglobin tests for COVID-19
within two hours. All non-urgent gynecologic surgeries were suspended on
January 25, 2020 and have resumed on March 23, 2020 due to uncontrolled
COVID-19. In our community, we have volunteers that check the status of
Health code to monitor people who have yellow or red code.
Society of Obstetrics and Gynecology, Soochow, have taken measures in
response to the COVID-19 outbreak. Substantial online education on
protective actions for pregnant women was implemented for each
obstetrician. Apps like WeChat and hotline have been set up for pregnant
women to counsel their symptoms. Patients with abnormal complaints have
received attention quickly. However, we still do not have efficient
management of pregnant women with COVID-19. Due to extreme precautions,
pregnant women were not profoundly affected by COVID-19 in Soochow.