A New Multiplatform Model for Outpatient Prenatal and Postpartum Care in a Cohort of COVID-19-Affected Obstetric Patients

Abstract

Spain was one of the epicenters of the first wave of the COVID-19 pandemic. We describe in this article the design and results of a new telephone-and-telematic multiplatform model of systematic prenatal and postpartum follow-up for COVID-19-affected women implemented in a tertiary reference hospital in Madrid. We included patients with RT-PCR-confirmed COVID-19 during pregnancy or delivery from 10 March 2020 to 15 December 2020. We had a total of 211 obstetric patients: 148 (70.1%) were tested at the onset of suspicious clinical manifestations and 62 (29.4%) were tested in the context of routine screening. Of all the patients, 60 women (28.4%) were asymptomatic and 97 (46%) presented mild symptoms. Fifty-one women (24.2%) were admitted to our hospital for specific treatment because of moderate or severe symptoms. We had no missed cases and a good adherence. The mean number of calls per patient was 2.3. We performed 55 in-person visits. We analyzed the complexity of our program over time, showing a two-wave-like pattern. One patient was identified as needing hospitalization and we did not record major morbidity. Telemedicine programs are a strong and reproducible tool to reach to pregnant population affected by COVID-19, to assess its symptoms and severity, and to record for pregnancy-related symptoms both in an outpatient regime and after discharge from hospital.

Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study

“…From March 9, 2020, to June 11, 2022, we assisted in a total of 10,737 deliveries and treated 409 (3.8%) patients with confirmed COVID-19 infection during pregnancy or delivery in our centre. Patients suffering from acute infection during pregnancy or delivery were evaluated and treated within the COVID-19 and pregnancy program 13 and were offered participation in our study through telephone clinical follow-up until delivery and after to evaluate symptomatic recovery. Fig.…”

“…The design of the study started from a multipurpose cohort of hospitalised and nonhospitalised women, and follow-up was performed through semistructured telephone questionnaires. 13 , 28 This may have limited our study since the information extracted from our questionnaires may have presented some bias due to subjectivity, specific language limitations or memory constraints. Women were often contacted while at home with family members, which may have limited or overrate the expression of malaise or the perception and accuracy of the description of their symptoms.…”

“…We designed a prospective observational study of a hospital-based multipurpose obstetric and perinatal cohort including pregnant women enrolled in the COVID-19 and pregnancy programme 13 at a tertiary referral centre in Madrid. All women included were referred to the programme because of a confirmed positive COVID-19 test during pregnancy or at admission for labour, after discharge from the emergency room, after hospitalisation or after the confirmation of COVID-19 infection in obstetric or primary care consultations.…”

“…All women included were referred to the programme because of a confirmed positive COVID-19 test during pregnancy or at admission for labour, after discharge from the emergency room, after hospitalisation or after the confirmation of COVID-19 infection in obstetric or primary care consultations. 13 …”

“…We performed clinical follow-up via telephone during the acute phase 13 and a postacute systematic clinical survey via telephone from November 11th, 2021, to September 15th, 2022 ( Appendix ). The items included in the systematic questionnaire were based on the Delphi consensus for post-COVID-19 condition.…”