Obstetrics in the time of Coronavirus: A Tertiary Maternity Centre’s
Preparations and Experience during the COVID-19 Pandemic
Objective Since the outbreak of Coronavirus Disease 2019 (COVID-19) in
Singapore in January 2020, our maternity centre at Singapore General
Hospital has devised and implemented contingency protocols to manage
COVID-19 suspected or infected pregnant mothers. These aimed to deliver
effective care while ensuring the safety of our front-line healthcare
Methods The epidemiology and pathogenicity of SARS-COV-2 was
compared to the Severe Acute Respiratory Syndrome outbreak in 2003. Our
protocols were constructed following multidisciplinary discussions.
These workflow processes include triage, isolation, determination of
admission criteria and subsequent secured transfers to dedicated
isolation wards. Intrapartum management policies including mode of
delivery were reviewed with the focus on minimising maternal-fetal
transmission. Postpartum care (breastfeeding and skin-to-skin contact)
policies were re-evaluated.
Results The Centre conducted several
multidisciplinary in-situ simulations which identified potential latent
threats and deficiencies in infection containment. These were gaps in
communication and co-ordination between operating theatre, obstetrics
and neonatal teams resulting in delayed transfers. A particular
vulnerability was the consistent breaches observed in the donning and
doffing of personal protective equipment. This led to a need for
additional personnel to guide and police strict adherence among
Conclusion Operational readiness leverage on robust
contingency protocols which must be subjected to simulation and scrutiny
with subsequent revision. We recommend deploying additional supervisory
manpower to maintain strict adherence to infection prevention protocols.
Effective preparation is key in maintaining high clinical standards of
obstetric care while ensuring safety of healthcare workers during this
Funding No funding nor conflicts of interest.