Gynecologic Teleultrasound and COVID‐19

Abstract

Relying on the experience and following the constantly changing and adapting circumstances related to patient care forced upon the health care system in general and upon patients in need of gynecologic diseases in particular the goal was to try to maintain the best possible patient care. Out of sheer necessity, starting in March 2020, "in-person" US evaluation of gynecologic patients was effectively shut down. However, also due to necessity, care of pregnancies, or strictly pregnancy-related diseases, did not cease during the above period. "In-person" ultrasound (US) scanning of pregnant patients to evaluate fetal anatomy and pregnancy parameters continued despite severe restrictions of provider and patient contact. Preventative and cautionary measures were set in motion to curtail, or at least to minimize spread of disease, while providing necessary obstetrical and maternal and fetal high-risk care.The situation regarding the gynecologic patients was totally different. To comply with infection control issues practically all diagnostic and therapeutic services of gynecologic diseased were curtailed coming practically to a standstill. Emergency cases were exceptions. Office gynecology including gynecologic US were first to close leading to minimal use of operating facilities. This also included and extended affecting even the evaluation, imaging, and treatment of oncologic patients. Various solutions to maintain patient care were introduced. Among them were telephone and video patient consultations that lasted throughout much of 2020 and still selectively going on. While before we were interacting directly with patients undergoing US evaluation, remote US image reading was added to avoid direct patient provider contact. Sonographers were in the forefront of obtaining the necessary transmitted images, thus the quality of the information was dependent on their expertise and experience. Thus, confirming, evaluating, "fine-tuning" or ruling out findings based upon "frozen" US images and verbal reports by sonographers was difficult and at times incomplete. Streaming Video online at jultrasoundmed.org