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Article ; Online: Adverse outcomes in early term versus full-term deliveries among higher-order cesarean births.

McLaren, Rodney / London, Viktoriya / Stein, Janet L / Minkoff, Howard

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

2021 Volume 35, Issue 25, Page(s) 5464–5469

Abstract: Objective: In an attempt to avoid emergency deliveries of women with multiple prior scars, providers may choose to schedule those repeat cesarean births prior to 39 weeks. Our primary goal was to compare rates of assisted ventilation use between ... ...

Abstract	Objective: In an attempt to avoid emergency deliveries of women with multiple prior scars, providers may choose to schedule those repeat cesarean births prior to 39 weeks. Our primary goal was to compare rates of assisted ventilation use between neonates with early term (37°-38 Methods: A retrospective cohort study of women with three or more previous cesarean births. The study group consisted of women who delivered at early term (37°-38 Results: A total of 28,584 women with three or more prior cesarean births were included. There were 12,391 women who delivered at early term, and 16,193 who delivered at full term. Neonates born from women who delivered at early term had an increased risk of assisted ventilation use greater than 6 h compared with neonates who delivered at full term (assisted ventilation greater than 6 h, adjusted odds ratio (aOR) 2.08, 95% confidence interval (CI) [1.59-2.73]). Neonates delivered at early term were also more likely to need immediate ventilation use than were neonates delivered at full term (aOR 1.52, 95% CI [1.33-1.73]). Women who delivered at early term had a higher rate of uterine rupture compared with women who delivered at full term (OR 5.67, 95% CI [2.33-13.79]). Conclusion: Higher order cesarean births performed early term had an increased risk of neonatal assisted ventilation use greater than 6 h compared with full-term births. These results argue against delivering women with multiple prior uterine scars before term in an attempt to avoid emergency sections.
MeSH term(s)	Pregnancy ; Infant, Newborn ; Female ; United States ; Humans ; Uterine Rupture/etiology ; Retrospective Studies ; Cicatrix/complications ; Cesarean Section/adverse effects ; Gestational Age
Language	English
Publishing date	2021-02-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2077261-0
ISSN	1476-4954 ; 1057-0802 ; 1476-7058
ISSN (online)	1476-4954
ISSN	1057-0802 ; 1476-7058
DOI	10.1080/14767058.2021.1882985
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Article ; Online: Cesarean Birth Morbidity among Women with SARS-CoV-2.

McLaren, Rodney / London, Viktoriya / Narayanamoorthy, Sujatha / Atallah, Fouad / Silver, Michael / Minkoff, Howard

American journal of perinatology

2021 Volume 40, Issue 12, Page(s) 1367–1372

Abstract: Objective: The objective of this study was to compare maternal outcomes of women with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who underwent cesarean births.: Study design: This was a matched cohort study of ...

Abstract	Objective: The objective of this study was to compare maternal outcomes of women with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who underwent cesarean births. Study design: This was a matched cohort study of pregnant women who had a cesarean birth between March 15, 2020, and May 20, 2020. Cases included women who tested positive for SARS-CoV-2. For every case, two patients who tested negative for SARS-CoV-2 were matched by maternal age, gestational age, body mass index, primary or repeat cesarean birth, and whether the procedure was scheduled or unscheduled. We compared rates of adverse postcesarean complications (intraoperative bladder or bowel injury, estimated blood loss more than or equal to 1,000 mL, hemoglobin drop more than 3 g/dL, hematocrit drop more than 10%, need for blood transfusion, need for hysterectomy, maternal intensive care unit admission, postoperative fever, and development of surgical site infection), with the primary outcome being a composite of those outcomes. We also assessed duration of postoperative stay. Fisher's exact tests were performed to compare the primary outcome between both groups. Results: Between March and May 2020, 202 women who subsequently underwent cesarean birth were tested for SARS-CoV-2. Of those 202, 43 (21.3%) patients were positive. They were matched to 86 patients who tested negative. There was no significant difference in the rate of composite adverse surgical outcomes between the groups (SARS-CoV-2 infected 27.9%, SARS-CoV-2 uninfected 25.6%; Conclusion: Pregnant women with SARS-CoV-2 who underwent a cesarean birth did not have an increased risk of adverse surgical outcomes, other than fever, compared with pregnant women without SARS-CoV-2. Key points: · Women with SARS-CoV-2 had more postoperative fevers.. · Length of stay did not differ based on SARS-CoV-2 status.. · Composite postoperative outcome did not differ based on SARS-CoV-2 status..
MeSH term(s)	Pregnancy ; Female ; Humans ; SARS-CoV-2 ; COVID-19/epidemiology ; Cohort Studies ; Pregnancy Complications, Infectious/epidemiology ; Premature Birth ; Morbidity ; Fever ; Pregnancy Outcome
Language	English
Publishing date	2021-11-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/s-0041-1739430
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Article ; Online: Temporal Trend in SARS-CoV-2 Symptoms in Pregnant Women.

London, Viktoriya / Blitz, Matthew J / Solmonovich, Rachel / Silver, Michael / Minkoff, Howard

American journal of perinatology

2021 Volume 40, Issue 11, Page(s) 1259–1264

Abstract: Objective: The objective of this study was to examine temporal trends in the clinical presentation of patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnancy.: Study design: This is a retrospective cohort ... ...

Abstract	Objective: The objective of this study was to examine temporal trends in the clinical presentation of patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnancy. Study design: This is a retrospective cohort study of pregnant women who were universally screened for SARS-CoV-2 and tested positive. This multi-center study of admissions to labor and delivery units in New York City and Long Island included all SARS-CoV-2-infected pregnant women admitted to labor and delivery units between April 10th and June 4th 2020. Six Northwell Health hospitals and Maimonides Medical Center were included in the study. The main measures of the study included patient reports of COVID-19 symptoms: fever, cough, chest pain, shortness of breath, nausea, vomiting, and intensive care unit (ICU) admissions. The main outcome measure was the percentage of all infected women who reported any of the above symptoms. Results: In total, 427 infected pregnant women were included in the study. There was a statistically significant decline in the percentage of patients presenting with any symptoms over the course of the study. In addition, disease severity, symptoms of fever, cough, and chest pain/shortness of breath also significantly declined over time, and no ICU admissions were noted after the third week of April. Conclusion: There was a temporal shift away from symptomatic presentation in pregnant women diagnosed with SARS-CoV-2 over the course of the first months of the epidemic in New York. Further studies are necessary to elucidate the cause of this change in presentation among pregnant women, to determine whether this trend is also observed in other patient populations. Key points: · Retrospective cohort review of 427 SARS-CoV-2-infected pregnant women admitted to labor and delivery units.. · A significant decline in the percentage of patients presenting with symptoms over time was noted.. · Further studies are necessary to elucidate the cause of this change in presentation.. · Theories for the noted trend: viral evolution, decreased viral inoculums, and prolonged polymerase chain reaction positivity..
MeSH term(s)	Female ; Humans ; Pregnancy ; SARS-CoV-2 ; COVID-19/diagnosis ; COVID-19/epidemiology ; Retrospective Studies ; Pregnant Women ; Cough/etiology ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/epidemiology ; Labor, Obstetric ; New York City/epidemiology
Language	English
Publishing date	2021-12-16
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/s-0041-1739490
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Article ; Online: Delivery for respiratory compromise among pregnant women with coronavirus disease 2019.

McLaren, Rodney A / London, Viktoriya / Atallah, Fouad / McCalla, Sandra / Haberman, Shoshana / Fisher, Nelli / Stein, Janet L / Minkoff, Howard L

American journal of obstetrics and gynecology

2020 Volume 223, Issue 3, Page(s) 451–453

MeSH term(s)	Adult ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Delivery, Obstetric ; Female ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Pregnancy ; Pregnancy Complications, Infectious ; Respiratory Distress Syndrome/therapy ; Retrospective Studies ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-23
Publishing country	United States
Document type	Letter ; Observational Study
ZDB-ID	80016-8
ISSN	1097-6868 ; 0002-9378
ISSN (online)	1097-6868
ISSN	0002-9378
DOI	10.1016/j.ajog.2020.05.035
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Article ; Online: The use of bilateral transversus abdominis plane blocks with liposomal bupivacaine on postoperative cesarean delivery patients during COVID-19 pandemic is associated with reduced narcotics use and reduced length of stay.

Feierman, Dennis E / Kim, Jason / Bronstein, Aden / Miller, Agnes / Dgheim, Christein / London, Viktoriya / Alter, Avram / Tyagaraj, Kalpana

Women's health (London, England)

2021 Volume 17, Page(s) 17455065211058046

Abstract: Background: The use of transversus abdominis plane blocks has been previously shown in both large-scale studies and our own institution to significantly reduce postoperative pain and opioid use. In addition, the use of bilateral transversus abdominis ... ...

Abstract	Background: The use of transversus abdominis plane blocks has been previously shown in both large-scale studies and our own institution to significantly reduce postoperative pain and opioid use. In addition, the use of bilateral transversus abdominis plane blocks using liposomal bupivacaine in combination with neuraxial morphine significantly reduced post-cesarean-delivery pain and opioid use. During the COVID-19 crisis, our anesthesia department in a collaborative effort with our obstetric colleagues thought that the use of bilateral transversus abdominis plane blocks with liposomal bupivacaine could reduce the use of opioids to treat postoperative pain and might result in decreased length of stay. Methods: After institutional review board approval, a retrospective study of 288 patients who underwent cesarean delivery under spinal or epidural (neuraxial) anesthesia at Maimonides Medical Center in Brooklyn, NY was conducted. Historical controls were from 142 consecutive patients from 1 January 2012 through 12 May 2012. An additional set of controls consisted of 30 consecutive patients from 10 March 2020 through 13 April 2020. The primary outcome data analyzed were the use of opioids and length of stay. Results: Post cesarean delivery, patients who received both bilateral transversus abdominis plane blocks with liposomal bupivacaine and neuraxial morphine was associated with a significant decrease in the number of patients using post operative opioids, 54%-60% decreased to 18% ( Conclusion: Neuraxial opioids combined with liposomal bupivacaine transversus abdominis plane blocks provided significant pain relief for patients post cesarean delivery, required less post operative opioids, and facilitated earlier discharge that may aid in reducing patient exposure and hospital burden secondary to COVID-19.
MeSH term(s)	Abdominal Muscles ; Anesthetics, Local ; Bupivacaine ; COVID-19 ; Female ; Humans ; Length of Stay ; Narcotics ; Pandemics ; Pregnancy ; Retrospective Studies ; SARS-CoV-2
Chemical Substances	Anesthetics, Local ; Narcotics ; Bupivacaine (Y8335394RO)
Language	English
Publishing date	2021-11-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2274503-8
ISSN	1745-5065 ; 1745-5057
ISSN (online)	1745-5065
ISSN	1745-5057
DOI	10.1177/17455065211058046
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Article ; Online: The use of bilateral transversus abdominis plane blocks with liposomal bupivacaine on postoperative cesarean delivery patients during COVID-19 pandemic is associated with reduced narcotics use and reduced length of stay

Dennis E Feierman / Jason Kim / Aden Bronstein / Agnes Miller / Christein Dgheim / Viktoriya London / Avram Alter / Kalpana Tyagaraj

Women's Health, Vol

2021 Volume 17

Abstract	Background: The use of transversus abdominis plane blocks has been previously shown in both large-scale studies and our own institution to significantly reduce postoperative pain and opioid use. In addition, the use of bilateral transversus abdominis plane blocks using liposomal bupivacaine in combination with neuraxial morphine significantly reduced post-cesarean-delivery pain and opioid use. During the COVID-19 crisis, our anesthesia department in a collaborative effort with our obstetric colleagues thought that the use of bilateral transversus abdominis plane blocks with liposomal bupivacaine could reduce the use of opioids to treat postoperative pain and might result in decreased length of stay. Methods: After institutional review board approval, a retrospective study of 288 patients who underwent cesarean delivery under spinal or epidural (neuraxial) anesthesia at Maimonides Medical Center in Brooklyn, NY was conducted. Historical controls were from 142 consecutive patients from 1 January 2012 through 12 May 2012. An additional set of controls consisted of 30 consecutive patients from 10 March 2020 through 13 April 2020. The primary outcome data analyzed were the use of opioids and length of stay. Results: Post cesarean delivery, patients who received both bilateral transversus abdominis plane blocks with liposomal bupivacaine and neuraxial morphine was associated with a significant decrease in the number of patients using post operative opioids, 54%–60% decreased to 18% ( p < 0.001), and a decreased length of stay; 3.1 days was reduced to 2.39 ( p < 0.001). Conclusion: Neuraxial opioids combined with liposomal bupivacaine transversus abdominis plane blocks provided significant pain relief for patients post cesarean delivery, required less post operative opioids, and facilitated earlier discharge that may aid in reducing patient exposure and hospital burden secondary to COVID-19.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Grand Multiparity and Obstetric Outcomes in a Contemporary Cohort: The Role of Increasing Parity.

DeBolt, Chelsea A / Rao, Manasa G / Limaye, Meghana A / London, Viktoriya / Sagaram, Deepika / Roman, Ashley S / Minkoff, Howard / Bernstein, Peter S / Overbey, Jessica R / Kaplowitz, Elianna / Meislin, Rachel / Toner, Lorraine E / Khander, Amrin / Bigelow, Catherine A / Stone, Joanne

American journal of perinatology

2023 Volume 41, Issue 7, Page(s) 815–825

Abstract: Objective: Evidence is inconsistent regarding grand multiparity and its association with adverse obstetric outcomes. Few large American cohorts of grand multiparas have been studied. We assessed if increasing parity among grand multiparas is associated ...

Abstract	Objective: Evidence is inconsistent regarding grand multiparity and its association with adverse obstetric outcomes. Few large American cohorts of grand multiparas have been studied. We assessed if increasing parity among grand multiparas is associated with increased odds of adverse perinatal outcomes. Study design: Multicenter retrospective cohort of patients with parity ≥ 5 who delivered a singleton gestation in New York City from 2011 to 2019. Outcomes included postpartum hemorrhage, preterm delivery, hypertensive disorders of pregnancy, shoulder dystocia, birth weight > 4,000 and <2,500 g, and neonatal intensive care unit (NICU) admission. Parity was analyzed continuously, and multivariate analysis determined if increasing parity and other obstetric variables were associated with each adverse outcome. Results: There were 2,496 patients who met inclusion criteria. Increasing parity among grand multiparas was not associated with any of the prespecified adverse outcomes. Odds of postpartum hemorrhage increased with history (adjusted odds ratio [aOR]: 2.65, 95% confidence interval [1.83, 3.84]) and current cesarean delivery (aOR: 4.59 [3.40, 6.18]). Preterm delivery was associated with history (aOR: 12.36 [8.70-17.58]) and non-White race (aOR: 1.90 [1.27, 2.84]). Odds of shoulder dystocia increased with history (aOR: 5.89 [3.22, 10.79]) and birth weight > 4,000 g (aOR: 9.94 [6.32, 15.65]). Birth weight > 4,000 g was associated with maternal obesity (aOR: 2.92 [2.22, 3.84]). Birth weight < 2,500 g was associated with advanced maternal age (aOR: 1.69 [1.15, 2.48]), chronic hypertension (aOR: 2.45 [1.32, 4.53]), and non-White race (aOR: 2.47 [1.66, 3.68]). Odds of hypertensive disorders of pregnancy increased with advanced maternal age (aOR: 1.79 [1.25, 2.56]), history (aOR: 10.09 [6.77-15.04]), and non-White race (aOR: 2.79 [1.95, 4.00]). NICU admission was associated with advanced maternal age (aOR: 1.47 [1.06, 2.02]) and non-White race (aOR: 2.57 [1.84, 3.58]). Conclusion: Among grand multiparous patients, the risk factor for adverse maternal, obstetric, and neonatal outcomes appears to be occurrence of those adverse events in a prior pregnancy and not increasing parity itself. Key points: · Increasing parity is not associated with adverse obstetric outcomes among grand multiparas.. · Prior adverse pregnancy outcome is a risk factor for the outcome among grand multiparas.. · Advanced maternal age is associated with adverse obstetric outcomes among grand multiparas..
MeSH term(s)	Humans ; Female ; Pregnancy ; Retrospective Studies ; Adult ; Parity ; Postpartum Hemorrhage/epidemiology ; Infant, Newborn ; Premature Birth/epidemiology ; Pregnancy Outcome/epidemiology ; Cesarean Section/statistics & numerical data ; Hypertension, Pregnancy-Induced/epidemiology ; Shoulder Dystocia/epidemiology ; New York City/epidemiology ; Young Adult ; Risk Factors ; Intensive Care Units, Neonatal/statistics & numerical data ; Birth Weight
Language	English
Publishing date	2023-12-06
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/a-2223-6093
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Article: Temporal Trend in SARS-CoV-2 Symptoms in Pregnant Women

London, Viktoriya / Blitz, Matthew J. / Solmonovich, Rachel / Silver, Michael / Minkoff, Howard

American Journal of Perinatology

2021 Volume 40, Issue 11, Page(s) 1259–1264

Abstract	Objective: The objective of this study was to examine temporal trends in the clinical presentation of patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnancy. Study Design: This is a retrospective cohort study of pregnant women who were universally screened for SARS-CoV-2 and tested positive. This multi-center study of admissions to labor and delivery units in New York City and Long Island included all SARS-CoV-2-infected pregnant women admitted to labor and delivery units between April 10th and June 4th 2020. Six Northwell Health hospitals and Maimonides Medical Center were included in the study. The main measures of the study included patient reports of COVID-19 symptoms: fever, cough, chest pain, shortness of breath, nausea, vomiting, and intensive care unit (ICU) admissions. The main outcome measure was the percentage of all infected women who reported any of the above symptoms. Results: In total, 427 infected pregnant women were included in the study. There was a statistically significant decline in the percentage of patients presenting with any symptoms over the course of the study. In addition, disease severity, symptoms of fever, cough, and chest pain/shortness of breath also significantly declined over time, and no ICU admissions were noted after the third week of April. Conclusion: There was a temporal shift away from symptomatic presentation in pregnant women diagnosed with SARS-CoV-2 over the course of the first months of the epidemic in New York. Further studies are necessary to elucidate the cause of this change in presentation among pregnant women, to determine whether this trend is also observed in other patient populations. Key Points: Retrospective cohort review of 427 SARS-CoV-2-infected pregnant women admitted to labor and delivery units. A significant decline in the percentage of patients presenting with symptoms over time was noted. Further studies are necessary to elucidate the cause of this change in presentation. Theories for the noted trend: viral evolution, decreased viral inoculums, and prolonged polymerase chain reaction positivity.
Keywords	SARS-CoV-2 ; pregnancy ; temporal trend ; clinical presentation
Language	English
Publishing date	2021-12-16
Publisher	Thieme Medical Publishers, Inc.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/s-0041-1739490
Database	Thieme publisher's database

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Article: Cesarean Birth Morbidity among Women with SARS-CoV-2

McLaren, Rodney / London, Viktoriya / Narayanamoorthy, Sujatha / Atallah, Fouad / Silver, Michael / Minkoff, Howard

American Journal of Perinatology

2021 Volume 40, Issue 12, Page(s) 1367–1372

Abstract	Objective: The objective of this study was to compare maternal outcomes of women with and without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who underwent cesarean births. Study Design: This was a matched cohort study of pregnant women who had a cesarean birth between March 15, 2020, and May 20, 2020. Cases included women who tested positive for SARS-CoV-2. For every case, two patients who tested negative for SARS-CoV-2 were matched by maternal age, gestational age, body mass index, primary or repeat cesarean birth, and whether the procedure was scheduled or unscheduled. We compared rates of adverse postcesarean complications (intraoperative bladder or bowel injury, estimated blood loss more than or equal to 1,000 mL, hemoglobin drop more than 3 g/dL, hematocrit drop more than 10%, need for blood transfusion, need for hysterectomy, maternal intensive care unit admission, postoperative fever, and development of surgical site infection), with the primary outcome being a composite of those outcomes. We also assessed duration of postoperative stay. Fisher's exact tests were performed to compare the primary outcome between both groups. Results: Between March and May 2020, 202 women who subsequently underwent cesarean birth were tested for SARS-CoV-2. Of those 202, 43 (21.3%) patients were positive. They were matched to 86 patients who tested negative. There was no significant difference in the rate of composite adverse surgical outcomes between the groups (SARS-CoV-2 infected 27.9%, SARS-CoV-2 uninfected 25.6%; p = 0.833). There was a higher rate of postoperative fevers (20.9 vs. 5.8%; p = 0.015), but that did not result in a longer length of stay ( p = 0.302). Conclusion: Pregnant women with SARS-CoV-2 who underwent a cesarean birth did not have an increased risk of adverse surgical outcomes, other than fever, compared with pregnant women without SARS-CoV-2. Key Points: Women with SARS-CoV-2 had more postoperative fevers. Length of stay did not differ based on SARS-CoV-2 status. Composite postoperative outcome did not differ based on SARS-CoV-2 status.
Keywords	cesarean birth ; COVID-19 ; novel coronavirus ; postoperative outcome ; SARS-CoV-2
Language	English
Publishing date	2021-11-14
Publisher	Thieme Medical Publishers, Inc.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/s-0041-1739430
Database	Thieme publisher's database

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Article ; Online: Caring for Pregnant Patients with COVID-19: Practical Tips Getting from Policy to Practice.

London, Viktoriya / McLaren, Rodney / Stein, Janet / Atallah, Fouad / Fisher, Nelli / Haberman, Shoshana / McCalla, Sandra / Minkoff, Howard

American journal of perinatology

2020 Volume 37, Issue 8, Page(s) 850–853

Abstract: Novel coronavirus disease 2019 (COVID-19) is a pandemic with most American cases in New York. As an institution residing in a high-prevalence zip code, with over 8,000 births annually, we have cared for over 80 COVID-19-infected pregnant women, and have ... ...

Abstract	Novel coronavirus disease 2019 (COVID-19) is a pandemic with most American cases in New York. As an institution residing in a high-prevalence zip code, with over 8,000 births annually, we have cared for over 80 COVID-19-infected pregnant women, and have encountered many challenges in applying new national standards for care. In this article, we review how to change outpatient and inpatient practices, develop, and disseminate new hospital protocols, and we highlight the psychosocial challenges for pregnant patients and their providers. KEY POINTS: · Novel coronavirus disease 2019 (COVID-19) information rapidly changes.. · Multidisciplinary communication is key.. · This study addresses psychosocial challenges..
MeSH term(s)	Betacoronavirus/isolation & purification ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Evidence-Based Practice/trends ; Female ; Humans ; Infection Control/methods ; Infection Control/organization & administration ; Interdisciplinary Communication ; Obstetrics/organization & administration ; Obstetrics/trends ; Organizational Innovation ; Pandemics/prevention & control ; Perinatal Care/methods ; Perinatal Care/organization & administration ; Perinatal Care/trends ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/prevention & control ; SARS-CoV-2 ; Standard of Care/trends ; United States/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-05-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/s-0040-1710539
Database	MEDical Literature Analysis and Retrieval System OnLINE

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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