Objective: to describe the impact of COVID-19 on the management of patients with ectopic pregnancy. Design: a multicentre study comparing outcomes from a prospective cohort during the pandemic [Covid-ectopic pregnancy registry (CEPR)] compared to an historical pre-pandemic cohort [non-Covid ectopic pregnancy registry (NCEPR)]. Setting: five London university hospitals. Population and Methods: consecutive patients diagnosed clinically and/or radiologically with ectopic pregnancy (March/2020-Aug/2020) were entered into the CEPR and an exploratory matched analysis was performed comparing results to NCEPR patients (January/2019-June/2019). Main outcome measures: patient demographics, management (expectant, medical and surgical), length of treatment, number of hospital visits (non-surgical management), length of stay (surgical management) and 30-day complications. Results: 341 patients met inclusion: 162 CEPR and 179 NCEPR. A significantly higher percentage of women underwent non-surgical management versus surgical management in the CEPR versus NCEPR (58.6% [95/162] vs 72.6% [130/179]; p= 0.0084]. Amongst patients managed with expectant management the CEPR had a significantly lower mean number of hospital visits compared to NCEPR [3.6 [SD 1.4] vs 13.7 [SD 13.4], p= 0.0053]. Amongst patients managed with medical management, the CEPR had a significantly lower mean number of hospital visits [NCEPR 6.4 [SD 2.3] vs 8.8 [SD 3.9], p= 0.0014]. There was no observed difference in complication rates between cohorts. Conclusion: women were found to undergo significantly higher rates of non-surgical management during COVID-19 first wave vs NCEPR cohort. Women managed non-surgically in CPER cohort were also managed with fewer hospital attendances. This did not lead to an increase in observed complications rates.

Objective To explore the impact of the COVID-19 pandemic on mental health of Obstetricians and Gynaecologists Study Design We performed a survey-based study from doctors working in the field of Obstetrics and Gynaecology across all Hospitals in United Kingdom. Surveyed information included demographics, past history of mental health conditions, screening for current symptoms of depression and anxiety, the significance of contributory factors and the effects of mental health on workplace behaviour. Results 207 doctors completed the survey. Of the respondents, 22.2% (n=46) had previously received treatment for a mental health condition. During the COVID-19 pandemic, O&G doctors as compared to UK-wide population estimate, reported significantly higher rates of both Major Depressive Disorder (15.94% versus 3.3%, p=0.023) and Generalised Anxiety Disorder (24.64% versus 5.9%, p=0.044). Sub-group analysis showed that anxiety was more common amongst female doctors as compared to males (27.5% versus 12.50%, p=0.047). Respondents felt that the most significant factors for work-related changes to mental health was keeping up to date with frequently changing guidelines and protocols related to COVID-19. Only 38.65% of respondents agreed that they felt able to talk to colleagues about their mental health. Conclusions This is the first reported study that assesses the impact of COVID-19 on mental health amongst Obstetricians and Gynaecologists. Further research should focus on assessing if changes in the way rapidly changing guidelines and protocols are disseminated reduces the impact on mental health. Ongoing efforts are also needed to improve support networks and encourage normality around discussing mental health amongst doctors

Objective To explore patients’ attitudes and acceptability of universal screening for COVID-19 in a maternity population. Design Pre-screening and post-screening patient surveys Setting London Population Women admitted to the Maternity Unit at Newham Hospital during a two-week trial period of universal screening. Methods Cluster random sampling was used to select participants to complete the pre-screening questionnaire. Post-screening questionnaires were performed over the telephone. Main outcome measured Agreement to statements regarding patient’s acceptability of the SARS-CoV-2 screening test and the impact screening had on the care provided to themselves and their babies. Results During the two-week period, 180 women underwent universal screening. 81 participants completed the pre-screening questionnaire and 79 participants completed the post-screening survey (72-85% completion rate). More than 70% of women agreed that routine screening resulted in a positive effect on their care, the care of their babies and on their families. More than 80% of women agreed that they would be happy with their care if all pregnant women were offered testing for COVID-19 on admission to hospital. However, 50.62% of women agreed that having a COVID-19 screening swab test taken was uncomfortable and 35.80% were worried about the test results. Nulliparous women were more likely to perceive the positive impacts of screening on their care, their babies care, and their families as compared to multiparous women. Conclusion Our study provides evidence that patient acceptability and tolerance to COVID-19 screening is high, which is key for future implementation of universal screening across maternity services in the UK.