Expert consensus on the management process of gynecological emergency under the regular epidemic prevention and control of COVID-19

At present,China is in the stage of the COVID-19 epidemic where regular prevention and control measures are required to contain the spread of disease.Reports of new sporadic cases are still widespread across China and medical personnel remain at high risk of exposure to infection.This is especially the case for medical staff working within emergency departments.Most gynecological emergency cases are complex and a high proportion require emergency surgical treatment.By referring to national regulations and requirements on COVID-19 prevention and control,and by summarizing our experiences in the battle against COVID-19 within Wuhan,this consensus report provides recommendations on the triage,reception,consultation,admission and surgical management of gynecological emergency patients.We also make suggestions for the environmental layout and disinfection and the medical waste management.This consensus aims to optimize the diagnosis and treatment process of gynecological emergency patients and reduce the exposure risk of medical staff within the current context of routine COVID-19 prevention and control.

Gynecological and Obstetrical Emergencies at the University Clinic of Gynecology-Obstetrics of the National Hospital Donka Guinea

Gynecological and obstetrical emergencies are found all over the world, especially in developing countries where women pay a heavy price for giving birth. They can occur at any time during pregnancy and outside of pregnancy often in a socio-economic context. The objectives of this study were to describe the sociodemographic characteristics and the maternal and fetal prognosis of gynecological and obstetric emergencies. Patients and Methods: This was a descriptive cross-sectional study with prospective data collection, conducted at the University Clinic of Gynecology and Obstetrics of the Donka National Hospital between June 1 and September 30, 2015. It involved all patients admitted to our department in emergency for a gynecological or obstetrical complaint. Results: We collected 361 cases of gynecological and obstetrical emergencies out of a total of 1779 consultations, i.e. a frequency of 20.29%. Obstetrical emergencies were predominant with 91.41% and gynecological emergencies represented 8.59%. The average age of patients was 29.5 with extremes of 14 and 47. Nulliparous women were the most numerous (34.35%). More than half of the patients did not attend school (52.08%) and 56.70% were evacuees. Abdominopelvic pain and hemorrhage were the main reasons for consultation (54.29% and 49.58%). Admission diagnoses were dominated by acute fetal distress and hemorrhage in the last quarter of pregnancy (52.3% and 36.01%). The caesarean section rate was high (82.12%). Maternal and perinatal lethality rates were high (5.2% and 30.3%). Conclusion: Gynecological and obstetrical emergencies are a public health issue because of the severity of the prognosis they impose on the mother and child. Maternal and perinatal mortality was very high. The prevention of these serious emergencies must be done through good quality prenatal consultations. Laparoscopy equipment and staff training are necessary for a minimal invasive surgery of gynecological emergencies.