Since December 2019, the new coronary virus (2019-NCOV) is popular in Wuhan. During the obstetrics department of the medical institutions in our province, there are suspected suspected and confirmed cases of pregnancy infection.All of each pregnancy age occurs, mainly manifested in the total number of fever, fatigue, dry cough, shortness of breath, and peripheral blood white cells, and the decrease in lymphocyte counting. Some cases are the primary manifestations of diarrhea.Virus -like pneumonia manifestations.
Pregnant women are the susceptible people of the virus, and the inflammatory emergency response of women infected with viral respiratory respiratory system during pregnancy has significantly increased, and the condition is rapid. Especially for middle and advanced pregnancy, it is susceptible to severe illnesses and needs to be observed closely.In order to regulate the management, the management strategy of new coronary virus infection is given now.
Postering fever pregnant women and suspected patients
1. Conditions for consultation medical institutions are required to send popular kidneys and obstetric treatment conditions
The fever and suspected pregnant women first conducted a pre -consultation, measured the body temperature and was guided by a special personnel to the specified hot kidnappers.
(1) Detecting body temperature, understanding if there are cough and chest tightness symptoms, and ask the medical history (whether the family heating personnel within 2 weeks are in contact with the South Seafood market of China).
(2) Suspected patients (fever ≥37.3 ° C, respiratory symptoms), immediately start conventional protection, screen (blood respiratory five pathogen pneumoniacura, chlamydia, respiratory virus, adenoviric virus, Kazakh virus IgM, pharynx wipe wipingTrinan virus nucleic acids of the air respiratory tract: respiratory tract syntoconis rna, type A influenza virus RNA, type B flu virus RNA, blood routine+CRP), such as the virus result is negative, immediately apply for a new type of coronary virus nucleic acid test to the Medical Office, go to fever, go to feverOutpatient.After signing, the chest CT examination understands the lung conditions (inform the patient’s necessity and the necessary abdominal protection).
(3) Inspection of obstetrics: When a popular kidney is issued, the obstetrician will consult and conduct obstetric examinations. For more than 28 weeks, fetal heart monitoring, ultrasonic assessment of intrauterine safety in the fetus can be performed.
1. Pregnancy combined with viral pneumonia develops rapidly. It is recommended to be separated and treated.
Mildness: Anti -virus: It is recommended to use FDA pregnancy safety level C drugs to avoid use of D drugs as as much as possible.Antibiotics: Choose FDA pregnancy safety level B drugs; if the pregnancy has been terminated as soon as possible; severe illnesses: such as <28 weeks of pregnancy weeks, mainly infected the treatment of infection, controlled by active treatment, and continuing pregnancy;Termination of pregnancy; cases of critical critical illness: In line with one of the following standards, immediately enter the intensive care unit and transfer designated medical institutions as soon as possible when conditions permit.Including: respiratory failure; pyrophydal shock; combined with other organ failure.2. Terminal pregnancy: requiring obstetrics, anesthesia, operating room, respiratory department, infection department, new, hospital, and medical office participation.3. Termination of pregnancy indicators and methods:
The condition is mild, the cervix conditions are good, you can choose vaginal delivery;
Surgery to terminate pregnancy indicators:
(1) Fetal distress;
(2) The condition control is not satisfactory, difficulty in breathing (the respiratory frequency is increased ≥30 times/minute), no oxygen conditions, oxygen saturation <93%; CT suggests large -scale viral pneumonia or lesions progress within 48 hours> 50%; Do not delay surgery due to dyspnea;
(3) Periodic but unable to give birth in a short time;
4. Anesthesia: even hard annex or general anesthesia.5. Precautions during surgery: Pay attention to the patient’s blood oxygen saturation during the operation. It is recommended to monitor the radial arteries puncture tube; the fetus is used as early as possible to promote uterine contraction drugs as soon as possible after delivery.Pay attention to the patient’s entry and exit to avoid increasing the cardiopulmonary burden of patients.Do you need to break the umbilical umbilical immediately and have no evidence.6. Postpartum isolation treatment: mainly treated in infection department.7. Related locations: Ward, delivery room, neonatal department, operating room, must have negative pressure isolation conditions, strengthen disinfection and isolation measures, and prepare isolation protection supplies in the above places.It is recommended to have a special room or isolation room or a special surgery room in the heating ward.
Protection recommendations for newborns
1. Newborns are recommended to be isolated for 10 to 14 days. The mother is not fed before the mother healed.
2. Due to the high fever and hypoxemia of pregnant women, internal distress and premature risk of premature birth in the fetus should be tightly monitored, and newborns should be quarantine and protection.
Heating, suspicion and diagnosis of pregnant women’s referrals
1. Referendum syndrome
The receiving unit does not have the ability to rescue the rescue of high -risk pregnant women and premature newborn; or patients with unstable condition, severe or critical illness patients.
2. Reverse process
The person in charge of the obstetrics department of the unit is evaluated to determine the referral, and the medical department of the medical department of the unit communicates with the relevant responsible persons of the medical department of the plan to be transferred, coordinate the consultation matters and introduce the written condition.
Source: Changjiang Cloud
Editor: Chen Yanjie | Editor: Natural
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