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Review
. 2021 Jun:73:22-39.
doi: 10.1016/j.bpobgyn.2021.03.006. Epub 2021 Mar 18.

Reducing the risk of infection to patients and staff during gynaecological outpatient and ambulatory appointments

Natalie Farmer  1 , Mary Connor  2
Affiliations
Review

Reducing the risk of infection to patients and staff during gynaecological outpatient and ambulatory appointments

Natalie Farmer et al. Best Pract Res Clin Obstet Gynaecol. 2021 Jun.

Abstract

This chapter explores ways to reduce the risk of severe acute respiratory syndrome coronavirus-2 transmission to women and staff within gynaecology outpatient clinics. The likely routes of transmission are discussed, namely through droplets, aerosols and fomites. Using the 'hierarchy of control' categories, elimination, substitution, engineering, administration and personal protective equipment, practical strategies for modifying virus exposure are presented. The management of specific clinical conditions are reviewed based on advice prepared by the specialist societies in conjunction with each other and the Royal College of Obstetricians and Gynaecologists. The need to maintain at least a minimal level of gynaecological services is recognised and that this should provide safe, equitable and effective care. Ways to reduce clinic attendance are discussed with the substitution of face-to-face with remote consultations and when this is relevant. Current recommendations for ambulatory procedures, which include colposcopy and hysteroscopy, are considered so that best use is made of reduced resources.

Keywords: Gynaecological services; Hierarchy of control; Personal protective equipment; Remote consultation; Triaging referrals.

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Conflict of interest statement

Declaration of competing interest Natalie Farmer: None. Mary Connor receives teaching honoraria and consultancy fees from Medtronic Medical Device Company, Covidien AG, Victor von Bruns-Strasse 19 8212, Neuhausen am Rheinfall, Switzerland.

Figures

Fig. 1
Fig. 1
Outpatient clinic arrangements illustrating adequate spacing between seats.
Fig. 2
Fig. 2
Illustration of the PPE to be worn in various circumstances.
Fig. 3
Fig. 3
Recommendations for eye protection to be worn during the COVID-19 pandemic.
See this image and copyright information in PMC

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