Minimizing cross transmission of SARS-CoV-2 in obstetric ultrasound during COVID-19 pandemic

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)–associated infection (COVID-19) is affecting populations worldwide. This statement may serve as guidance for infection prevention and safe ultrasound practices during the COVID-19 pandemic. Ultrasound examination is a fundamental part of obstetric care, yet it is a potential vector for transmission of SARS-CoV-2. Decontamination methods should always be implemented for ultrasound equipment, especially in the presence of suspected or confirmed COVID-19 cases. There must be workflow policies to protect pregnant women and healthcare providers from nosocomial cross transmission of SARS-CoV-2. Cleaning and disinfecting of equipment must be in accordance with their potential of pathogen transmission. Consider using telemedicine and genetic technologies as an adjunctive of obstetric ultrasound to reduce patient crowding. Patient triage and education of healthcare providers of infection prevention are crucial to minimize cross contamination of SARS-CoV-2 during obstetric ultrasound.

Clinical Issues — August 2023

“…13 Researchers in another study used adenosine triphosphate testing to evaluate the cleanliness of ultrasound equipment at five facilities in Australia and found that 46.4% of samples of ultrasound gel bottles were dirty-that is, "definitely unclean." 14(p889) If there is concern about cross-contamination, such as when using gel on a patient who requires contact precautions or has a suspected or confirmed COVID-19 infection, 15 personnel should either discard the multidose container after use or use single-use packets. 3,4 Personnel should consider multidose ultrasound transmission gel containers to be high-touch objects 4 when cleaning the environment between patients and clean the container in accordance with facility policy and the manufacturer's IFU.…”

“…If there is concern about cross‐contamination, such as when using gel on a patient who requires contact precautions or has a suspected or confirmed COVID‐19 infection, 15 personnel should either discard the multidose container after use or use single‐use packets 3,4 . Personnel should consider multidose ultrasound transmission gel containers to be high‐touch objects 4 when cleaning the environment between patients and clean the container in accordance with facility policy and the manufacturer's IFU.…”

Good practices for ultrasound examinations in gynecology and obstetrics during the COVID-19 pandemic

“…Precautions must be rigorous and systematic in the practice of this clinical activity, mainly because there is exposure of the patient and health professionals, given the impossibility of maintaining the recommended distance during the procedure. (1) The information found in this document is based on the best practices recommended by National and International Diagnostic Imaging Societies and guided by two main axes:…”

“…The COVID-19 pandemic period changed the routine of obstetric and gynecological ultrasound services, (1) as well as the routine in all other women's health care services. (2,3) Such changes involve a series of protective measures that will be highlighted in this regulation.…”

“…Precautions must be rigorous and systematic in the practice of this clinical activity, mainly because there is exposure of the patient and health professionals, given the impossibility of maintaining the recommended distance during the procedure. 1 …”