ISUOG Consensus Statement on rationalization of gynecological ultrasound services in context of SARS-CoV-2
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Consensus Statement on rationalization of early-pregnancy care and provision of ultrasonography in context of SARS-CoV-2 INTRODUCTIONIn view of the challenges of the current coronavirus (SARS-CoV-2) pandemic and to protect both patients and healthcare providers (physicians, sonographers, allied healthcare professionals), the International Society of Ultrasound of Obstetrics and Gynecology (ISUOG) has compiled the following evidence and expert-opinion-based guidance for the management of early-pregnancy complications.This statement provides proposals and options for managing patients referred for assessment by early-pregnancy healthcare practitioners during the coronavirus disease 2019 (COVID-19) pandemic.Transvaginal ultrasonography is a crucial part of clinical decision-making in early pregnancy.However, appropriate triage is now essential to allow prioritization of use of this resource by pregnancies at high risk of complications, mainly ectopic pregnancy, in which hospital visits will be safer than remote consultation.Temporarily reducing physical patient throughput will reduce the risk of SARS-CoV-2 transmission between patients and between patients and healthcare professionals.Clinicians carrying out ultrasound scans are in close proximity to patients for a significant period of time and have been shown to be at high risk of being infected by SARS-CoV-2 1 .Rationalizing patient visits and the provision of pregnancy care is vital to allow mobilization of staff and resources in response to this unprecedented pandemic whilst ensuring that women at risk of early-pregnancy complications continue to be safely cared for.Considering the inevitable reduction in resources and capacity, which limits the number of scan appointments available, we recommend that early-pregnancy appointments should be triaged to one of the following three options: Scans and/or visits that need to be undertaken without delay; Scans and/or visits that can be delayed without affecting clinical care; Scans and/or visits that can be avoided for the duration of the pandemic.This consensus statement focuses on women contacting their local early-pregnancy support services (e.g.early-pregnancy unit, emergency rooms with ultrasound, ultrasound clinic) with common complaints.Our proposed recommendations can be adapted to individual sites based on their resource availability and infrastructure, in order to continue to use ultrasound when indicated whilst reducing its use to the essential minimum.Guidance on rationalization of gynecological ultrasound services in the context of the COVID-19 pandemic have been provided in a separate document 2 .
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The International Society of Ultrasound in Obstetrics and Gynecology recommended postponing ultrasound evaluation of non-acute pelvic pain.
“In addition, the International Society of Ultrasound in Obstetrics and Gynecology has recommended postponing ultrasound evaluation of non-acute pelvic pain (Bourne et al., 2020).”
From Self-management strategies to consider to combat endometriosis symptoms during the COVID-19 pandemic (2020) · cites this paper as Bourne et al., 2020
The Details Recommended action section advises no routine scan during the pandemic for early-pregnancy patients with light bleeding and pain that is not troublesome. That supports postponement for a limited group, but our copy does not extend this recommendation to non-acute pelvic pain generally; it calls for a scan within 24 hours for pelvic pain in early pregnancy when no previous scan has been done. (LLM, conf=0.83)
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References 8 · Cited by 29
Research works printed but not linked: 4
- Herman MC, Mak N, Geomini PM, Winkens B, Mol BW, Bongers MY. Is the Pictorial Blood Loss Assessment Chart (PBAC) score associated with treatment outcome after endometrial ablation for heavy menstrual bleeding? A cohort study. BJOG 2017; 124: 277-282.
- Bobdiwala S, Saso S, Verbakel JY, Al-Memar M, Van Calster B, Timmerman D, Bourne T. Diagnostic protocols for the management of pregnancy of unknown location: A systematic review and meta-analysis. BJOG 2019; 126: 190-198.
- Bobdiwala S, Christodoulou E, Farren J, Mitchell-Jones N, Kyriacou C, Al-Memar M, Ayim F, Chohan B, Kirk E, Abughazza O, Guruwadahyarhalli, Guha S, Vathanan V, Bottomley C, Gould D, Stalder C, Timmerman D, Van Calster B, Bourne T. Triaging women with pregnancy of unknown location using two-step protocol including M6 model: clinical implementation study. Ultrasound Obstet Gynecol 2020; 55: 105-114.
- Mitchell-Jones N, Farren J, Tobias A, Bourne T, Bottomley C. Ambulatory versus inpatient management of severe nausea and vomiting in pregnancy: A randomized control trial with patient reference arm. BMJ Open 2017; 7: e017566.
- Authors
- Bourne, T., Leonardi, M., Kyriacou, C., Al‐Memar, M., Landolfo, C., Cibula, D., Condous, G., Metzger, U., Fischerova, D., Timmerman, D., & van den Bosch, T.
- Affiliations
- Universitair Ziekenhuis Leuven (BE)
- The University of Sydney (AU)
- Queen Charlotte's and Chelsea Hospital (GB)
- Agostino Gemelli University Polyclinic (IT)
- Charles University (CZ)
- Centre d'Échographie de l'Odéon Paris France
- Gynaecological Oncology Centre, Department of Obstetrics and Gynecology, First Faculty of Medicine Charles University and General University Hospital in Prague Prague Czech Republic
- Department of Obstetrics and Gynaecology University Hospitals Leuven Leuven Belgium
- Corresponding author
- Bourne, T.
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2020-06
- Volume
- 55
- Issue
- 6
- Pages
- 879-885
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- PMC
- PMC7262398
- OpenAlex
- W3014435625
- Cited by
- 29
- References
- 8
- Citations by year
- 2024: 2 · 2023: 3 · 2022: 4 · 2021: 9 · 2020: 11
- FWCI
- 4.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion, other-oa)
- The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
- Funders
- University of Vermont
- Imperial College London
- KU Leuven
- Universidad de Navarra
- Larner College of Medicine, University of Vermont
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › COVID-19 Impact on Reproduction
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Ultrasound in Clinical Applications
- Keywords
- COVID-19 pandemic, SARS-CoV-2, early pregnancy care, transvaginal ultrasound, triage, resource rationalization, ectopic pregnancy, early pregnancy complications, healthcare resource allocation
- MeSH terms
- Abscess, COVID-19, Pelvic Inflammatory Disease, Delivery of Health Care, Female, Genital Diseases, Female, Genital Neoplasms, Female, Gynecology, Humans, Ovarian Cysts, Ovarian Diseases, Pneumonia, Viral, Rupture, Spontaneous, Torsion Abnormality, Triage, Ultrasonography, Uterine Hemorrhage, Ovarian Hyperstimulation Syndrome, Infectious Disease Transmission, Professional-to-Patient, Infectious Disease Transmission, Patient-to-Professional, Coronavirus Infections, Pandemics
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