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NeoQIC: Care of Newborns Impacted by COVID-19 - Shared screen with speaker view
John Fiascone
24:28
John Fiascone at South Shore Hospital
Molly Fraust-Wylie
24:35
Molly Fraust Wylie, BIDMC
Lucienne Sanchez
24:45
Lucienne Sanchez Holy Family Hospital
joan Pezzano
24:49
Joan Pezzano Fairview Hospital
lmadore
25:06
Laura Madore Baystate Medical Center
Karen Karten
25:08
Karen Sussman-Karten from Boston Childrens Hospital
Dr Emily Whitesel
25:10
Hello! Emily Whitesel from BIDMC
Erica
25:13
Erica Anstey, Breastfeeding Specialist, CDC
mimi
25:23
Mimi Pomerleau BWH
Helen Healy
28:40
Helen Healy, fellow
Eirini Nestoridi
35:40
Are the tests for newborns done only in newborns br
Munish Gupta
35:59
Feel free to chat in comments or questions. If we don't have time to get to all questions, we can follow-up by email or next time!
Eirini Nestoridi
36:19
born to diagnosed with COVID-19 women, please?
Munish Gupta
36:51
Erini, those newborn screening questions were about all babies. All infants get CCHD, newborn screen, hepatitis B, etc.
Sheryl R Silva
37:05
Eirinni, Beverly, yes, babies born to PUI or covid + moms, if mom's test comes back neg baby is NOT tested
Eirini Nestoridi
39:03
Thanks, meant about COVID-19 tests for newborns. Thanks for the input.
Lucienne Sanchez
42:28
For Maria @ Mercy Hospital. Sick newborn sent to Baystate Med Ctr. ? full term vs preterm ? Mother COVID + ? outcome ? NB COVID +
Munish Gupta
45:25
Lucienne, we'll try not to discuss details of individual patients on these webinars, but we can put you in touch with Maria afterwards.
Lucienne Sanchez
45:46
THX
Silvia Patrizi
47:09
For mothers who refuse testing we are using full PPE as they are PUI and baby is rooming in
lmadore
47:37
At Baystate, if mom's refuse COVID testing and are asymptomatic then PPE is not worn. If symptoms then is treated as PUI
Zuzanna Kubicka
48:11
How is anybody else treating testing refusal?
Karen McAlmon
48:53
At Winchester, if mother's refuse COVID testing and are ASYMPTOMATIC then we do NOT treat as PUI.
Lucienne Sanchez
49:17
Are there any hospitals NOT testing all pregnant women upon arrival to L&D with rapid tests
Silvia Patrizi
49:22
Is anybody testing the asymptomatic support person of a Covid positive mom?
michael prendergast
49:27
We share same concern for asymptomatic +ve mothers who are separated - especially for mothers inexperienced at breastfeeding, even more so the ones looking (understandably) for an early discharge.
sblake
49:33
We had that situation here at Berkshire. We ended up leaving the baby in the room with the Mom
Karen McAlmon
49:35
We do not have a rapid test.
Zuzanna Kubicka
50:10
WE are testing mothers and partners 48h prior scheduled CS/induction. No universal testing yet
Karen McAlmon
50:16
At Winchester, we do universal testing but do not have a rapid test. We do not treat these mothers as PUI if they are asymptomatic.
Karen McAlmon
50:41
We also do pre C/S and induction tests about 48 hrs pta.
Zuzanna Kubicka
51:38
SSH has rapid test available for inpatient now
Zuzanna Kubicka
01:00:14
What is everyone doing for chorioamnionitis? Is mother treated as PUI?
Lcapra
01:00:42
Thank you so much to our presenters! Everyone is struggling with the same issues. One area that may lead to discussion/controversy is "how does one define joint medical decision making"?, Who has those discussions with the mothers and when? Are all options presented equally or is one option presented and other options are only mentioned if parents push back from the initial recommendation? What are the ethics in this scenario when there is so much unknown?
Karen McAlmon
01:00:49
At Winchester we treat mother and baby as PUI if there is fever during labor.
Leela Sarathy
01:01:43
Lisa - we are doing a prenatal consult whenever feasible. docs are using scripted consult template to provide overview of risks/benefits
sblake
01:01:53
What are others doing with mothers presenting with PP pre-eclampsia? Are yo testing them for Covid?
Munish Gupta
01:02:09
Zuzanna, intrapartum fever above 100.4 does make mom a PUI; for those moms, a rapid test comes back in a few hours.
Zuzanna Kubicka
01:02:18
No testing for PEC alone
Munish Gupta
01:02:32
We also don't test for pre-clampsia alone.
kellehma
01:02:53
great job Laura
Silvia Patrizi
01:03:02
We have universal testing at NWH. If mom develops fever and is not typical for chorio then we retest
Zuzanna Kubicka
01:03:19
Munish: Exactly; that is why we decided to do it and now we got results quickly
Munish Gupta
01:04:21
Lisa, for shared decision-making, we try to present rooming-in and separation as neutral options, but probably there is some favoring of rooming-in for term deliveries if mom isn't that sick.
Lcapra
01:04:28
with universal testing, what are the rates of asymptomatic positive mothers? Is it as high as the NYC experience?
Rachana Singh
01:05:03
Yes, a fair number of asymptomatic mothers are positive for us at Baystate
Silvia Patrizi
01:05:04
Within Partners hospitals , most recent data of Covid positive mothers picked up by universal testing in 0.1%
Tina Steele
01:05:41
BWH has had only 2 asymptomatic tested + moms
sblake
01:05:56
We have not seen any asymptomatic moms here at Berkshire yet
Lucienne Sanchez
01:06:07
Great idea to electively test support person!!
Eirini Nestoridi
01:06:51
What percent of mothers are found positive with universal testing, please?
Lcapra
01:06:57
Rate of asymptomatic positive mothers may influence how we treat mothers who refuse treatment. And it may vary by hospital/community. Lawrence has a very high amount of COVID in their community, Berkshires may not.
Munish Gupta
01:08:09
Eirini, I don't think we've seen formal data yet from Massachusetts centers on rates of asymptomatic positive moms. Just from the chats, you can see that it seems low in some centers and higher in others.
Munish Gupta
01:08:48
Lisa, agree. Our rate of asymptomatic positive is low at present, so if a mother declines testing, we do NOT consider her a PUI.
Margaret GK Parker
01:09:45
Re rooming in vs. separation: For folks involved in networks of hospitals- has there been a push to have a similar approach among the network or are individual hospitals approaching it differentely based on consensus of team and/or practical issues
Rachana Singh
01:10:28
3 out of our so far 10 positive mothers were asymptomatic so that is 30 %
Lcapra
01:10:40
Push to unify approach in Tufts network but some local variability based on resources/hospital culture
Leela Sarathy
01:10:41
Steward developed corporate policy that recommends separation, but with caveat that should be discussed beforehand with parents and mutual decision reached.
Sheryl R Silva
01:11:07
for beverly/lahey/BI there IS no delivery.baby care at Lahey so very much driven by Beverly, winchester and BI
Zuzanna Kubicka
01:11:09
Different approaches in different hospitals mostly due to differences in space
Karen McAlmon
01:11:25
Within BILH network have guidelines and then provide local context at individual hospitals based on logistics, etc.
Leela Sarathy
01:11:37
actual rates of separation depend on hospital resources and different individual culture
Silvia Patrizi
01:11:50
Mostly depends on Hospitals logistics due to space
Munish Gupta
01:12:53
Rachana, do you know what percent of your asymptomatic mothers were positive? So 3 out of how many mothers that were screened?
Munish Gupta
01:14:45
If you are interested, AAP SONPM registry has started sharing weekly updates of their data, every Friday. Report from last Friday had 102 mother/infant dyads. Is available through SONPM website, and here: https://my.visme.co/view/ojq9qq8e-npc-19-registry.
Rachana Singh
01:14:47
The rate if out of positive mothers - no one is currently keeping a count of how many are tested overall and then end up being negative.
Rachana Singh
01:15:44
Even for our bigger database for Baystate they are planning only on collecting data for positive patients. However the current prevalence rate for Baystate in about 17% out of all the tests done.
annvelie
01:16:23
At BWH <2% of asymptomatic mother’s have tested positive (>170 tested)
Silvia Patrizi
01:16:52
Are people making F/U calls to Covid pos families discharged from NICU?
Zuzanna Kubicka
01:17:20
If I remember correctly MGH reported during last Town Hall 6% positivity amongst screened mothers
Lucienne Sanchez
01:18:26
Applause for all presenters and organizers!! THANK YOU VERY MUCH!!!
Munish Gupta
01:18:43
Silvia, great question. We are not making follow-up calls, but we would like to. Are you? Anyone else?
Silvia Patrizi
01:19:05
We are staring now
Silvia Patrizi
01:19:17
starting
Lcapra
01:19:20
Great presentations all the way around! Thank you to organizers and presenters!
GWalker
01:19:21
Thank you very much for all these presentations! So helpful.
John Fiascone
01:21:20
Thank you all presenters. Interesting and helpful.
Lcapra
01:22:14
Would be great if DPH reported cases in infants <1month of age
Silvia Patrizi
01:22:54
I am interested to learn how many times newborns are tested, after the first at 24h, in Nursery or Nicu
Karen McAlmon
01:22:54
Thank you to all! Great to learn what others are doing. Really informs us about where we are and whether we should make changes or not.
ivanaculic
01:23:38
have to join another meeting. thank you all. bye
Munish Gupta
01:23:46
If anyone isn't getting our periodic emails about these COVID-19 webinars, please let me know and I will add you to that list.
Tanzeema H
01:24:03
Thank you for a great session!!
Sherman Chu
01:24:09
Thank you!
sblake
01:24:09
thank you everyone.
Deb B
01:24:10
thanks!
Silvia Patrizi
01:24:11
thank you