【病例分享】新冠疫情下的产科困境——哥伦比亚的一例病例报告
The following article is from 母胎医学杂志英文 Author 母胎医学杂志
在新冠大流行期间，由于对院内感染的恐惧，许多孕妇会选择家庭分娩。但在没有指定完善的计划时，贸然决定家庭分娩可能会对导致产妇和新生儿不良结局。本文介绍了一例哥伦比亚的案例，作者信息及中英文摘要如下：
Fear is the Path to the Dark Side: Unsafe Delivery, One of the Consequences of Fear of the SARS-CoV-2 Pandemic, A Case Report
Author: Nieto-Calvache, Albaro José; Padilla, Iván; Tabares-Blanco, Mario Fernando; López-Girón, María Camila; Vergara Galliadi, Lina María
Citation: Nieto-Calvache AJ, Padilla I, Tabares-Blanco MF, López-Girón MC, Vergara Galliadi LM. Fear is the Path to the Dark Side: Unsafe Delivery, One of the Consequences of Fear of the SARS-CoV-2 Pandemic, A Case Report. Maternal Fetal Med 2021;00:00. doi: 10.1097/FM9.0000000000000112.Indirect effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are difficult to calculate. Fear of intrahospital infection has led to a decrease in the use of emergency services and the performance of elective procedures. Several low- and middle-income countries have seen the number of institutional deliveries reduced, even in the absence of a follow-up program for home births. We present the case of a patient with adequate prenatal care and an institutional delivery plan who, due to the SARS-CoV-2 pandemic, chose to have a home delivery with unsafe conditions. The lack of supervision by health personnel and the absence of an immediate consultation plan facilitated the presentation of postpartum hemorrhage and poor neonatal results. Little attention has been paid during the pandemic to pregnant women who decide to have their birth at home. A broad discussion is necessary in this regard, to regain the confidence of the population and strengthen institutional births, or to strengthen midwife-assisted home births programs. Patients’ fear to acquiring SARS-CoV-2 infection inside hospitals is a factor that must be taken into account in prenatal care programs.
严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）大流行所造成的间接影响难以计算。对院内感染的恐惧不仅导致急诊就诊人数下降和择期手术减少，一些低收入和中等收入国家的住院分娩数量也明显下降，甚至在未制定家庭分娩计划的情况下也是如此。在本文介绍的案例中，患者进行了充分的产前护理且制定了住院分娩计划，但由于SARS-CoV-2大流行，选择了在不安全的条件下进行家庭分娩。由于缺乏医务人员的监护和及时会诊，导致了产后出血及新生儿不良结局。在这场大流行中，人们很少关注到家中分娩的孕产妇。在这方面有必要进行广泛、科学的讨论，使人们重拾信心，加强住院分娩，或加强有助产士负责的家庭分娩计划。孕产妇对在医院内感染SARS-CoV-2的恐惧是产前护理项目中必须考虑的一个因素。
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