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COVID-19 Obstetric, Neonatal, and NICU Guidelines

updated 10/25/23

For laboring mothers with a history of COVID-19 from which they have recovered, this provides recommendations regarding testing and isolation of both the laboring mother and her infant, based on the latest CDC guidance.

updated 12/21/23

Provides guidelines, protocols, and pathways for: 

updated 12/21/23

Provides a pathway with PPE guidance for NICU resuscitation teams in both vaginal and Cesarean delivery settings.

updated 9/3/20

Provides a pathway with PPE guidance for transporting a newborn from the delivery room to the NICU for COVID PUI infants. 

updated 10/25/23

Provides guidelines for NICU visitation (maternal and family), isolation, and testing for an infants born to a mother with confirmed COVID-19 disease or PUI, or for exposure to a positive parent during NICU hospitalization.

updated 2/9/23

Outborn or readmitted infants <72h/o will be tested directly with Rapid Respiratory Panel which includes COVID-19 PCR testing.

updated 11/17/22

St. Luke’s Children’s Hospital has created a tiered plan that can be activated to support a surge of patients due to high census numbers.  This plan is typically in place during the months of January through April, but may be implemented at other times as volumes dictate.

updated 10/26/21

Provides guidelines for breast milk handling for infants born to a mother with confirmed COVID-19 disease or PUI.

updated 3/27/20

Provides a process for responding to a code blue within the NICU for PUI or COVID-19 positive patients. 

updated 10/26/21

Provides guidance to providers and staff regarding the discharge process, including discharge education, for parents of infants discharged to a caregiver with confirmed COVID-19 disease or a PUI.

updated 10/26/21

Based on the CDC guidelines, provides parent instructions for care of the newborn at home after the mother has either been confirmed to have COVID-19 or is considered a PUI for COVID-19. 

See disclaimer here.

Additional COVID-19 Resources

Muge Cevik, Matthew Tate, Ollie Lloyd, Alberto Enrico Maraolo, Jenna Schafers, Antonia Ho. Published:November 19, 2020; DOI: https://doi.org/10.1016/S2666-5247(20)30172-5

A reliable source for the latest management and pharmacologic treatment recommendations for both inpatient and outpatient pediatric patients. 

Information to the public regarding the latest recommendations for pregnant and recently-delivered mothers with COVID-19 .  

A free repository of shared resources for clinicians in neonatology across the world.  

University of Washington has created a public site with several protocols, algorithms, guidelines, policies, and resource links in response to the COVID-19 outbreak.

Experts at Johns Hopkins provide free, up-to-date COVID-19 guidance, information, and unique content to help healthcare professionals. 

AAP provides answers to frequently asked questions related to the management of infants.

Provides information to help navigate the numbers with key metric descriptions and explanations for each data point included on the dashboard.

The Center for Systems Science and Engineering at Johns Hopkins University provides global data about the outbreak.

Provides infection trajectories by country along with several data points about the outbreak.

Provides data on testing, cases, cases among healthcare workers, hospitalizations, ICU admissions, and deaths within Idaho.

Disclaimer:  The COVID-related guidelines, pathways, and protocols included here are provided in good faith in this era of significant uncertainty and lack of solid high-quality evidence, particularly in the perinatal and pediatric arenas.  The approaches have been created from local, national, and international expert opinion.  Wherever possible, published evidence has been reviewed and incorporated.  Local factors such as current testing capacity, PPE availability, and personnel resources have influenced these approaches.  These resources have been created with input from leaders and providers in the following disciplines:  Obstetrics, Maternal Fetal Medicine, Neonatology, Pediatrics, Pediatric & Adult Infectious Disease, Infection Prevention, and others.

Guidelines and institutional practices related to COVID-19 are rapidly changing and providers should always refer to the most current information available.  This content is for informational purposes only and should not be construed or relied upon as a standard of care.  Good clinical judgement should always prevail when applying any standardized approach.  We recommend that institutions review these protocols, pathways, guidelines, and algorithms and accept, modify, or reject them based on their own institutional resources and patient populations.  Neonatology Solutions, LLC, assumes no liability for any outcomes arising from use of these tools. 

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Disclaimer:  All content above is solely the work product of the authors.  Neonatology Solutions, LLC, makes no endorsement or statement of safety, efficacy, or appropriateness of any of the protocols, pathways, guidelines, or algorithms contained within.  They should be thoroughly reviewed against any available evidence prior to adoption.  This content is for informational purposes only and should not be construed or relied upon as a standard of care.  Any questions or concerns should be directed to the authors and/or the listed contact person.  Good clinical judgement should always prevail when applying any standardized approach.  We recommend that institutions review these protocols, pathways, guidelines, and algorithms and accept, modify, or reject them based on their own institutional resources and patient populations.  Neonatology Solutions, LLC, assumes no liability for any outcomes arising from use of these tools.