Clinical guidelines for caring for women with COVID-19 during pregnancy, childbirth and the immediate postpartum period.
Pollyanna Pavlidis, Katherine Eddy, Laura Phung and 6 others
PMID 33191126WHAT IT FOUND
Early pandemic maternity guidance varied on nitrous oxide, birth companions, rooming-in, antenatal steroids, anticoagulants and antivirals, while agreeing to minimise visits, support breastfeeding, and not change birth mode solely for COVID-19.
Key findings
01The review identified 81 guidelines from 48 organisations, with 2205 recommendations for maternal and newborn care.
02Several practices had broad agreement: minimise face-to-face visits, support breastfeeding, and do not choose birth mode solely because of maternal COVID-19.
03Important disagreements included nitrous oxide, birth companions, rooming-in, antenatal corticosteroids, anticoagulants, antivirals and other disease-modifying agents.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not formally assess guideline quality because many guidelines were produced rapidly and lacked documentation of how recommendations were made. It was a snapshot up to 15 May 2020, and many guidelines were updated or removed, so recommendations may not reflect current practice. Few guidelines were reviewed in languages other than English, so non-English guidance may be underrepresented. The review reports guideline recommendations, not direct evidence that any intervention is safe or effective.
Declared interests
No funding was declared. The Editor-in-Chief of Women and Birth is a co-author, and the Deputy Editor managed the submission, peer review and all publication decisions.
The easy way to misread this
Do not read the number of guidelines or consensus as proof that an intervention works. The paper reports what organisations recommended, not patient outcomes, and the guidance was a snapshot from the early pandemic.