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COMMENTARY: Prioritizing outpatient gynecological care during COVID-19: The latest guidelines

What your doctor reads on Medscape.com:

APRIL 08, 2020 – What exactly constitutes appropriate outpatient gynecology on this time of social distancing?

On March 30, 2020, the American College of Obstetricians and Gynecologists (ACOG) spoke out and published COVID-19 FAQs for gynecologistsThese recommendations, which contain information on obstetric and gynecological operations, can be found to everyone, including most people, and are intended to enhance the rules from the Centers for Disease Control and Prevention and previously published ACOG Guide.

The recommendations include examples of patients who require in-person appointments or telehealth visits or whose visits must be postponed.

Personal appointments. Examples of patients for whom personal appointments are appropriate include those with suspected Ectopic pregnancy or heavy vaginal bleeding. Regarding Contraceptives ACOG recommends continuing placement of IUDs and implants so long as possible. If contraceptive placement is delayed, using self-administered hormonal contraceptives (including subcutaneous injections, oral administration, transdermal patches, and vaginal ring) must be encouraged as a bridge until later initiation of long-acting methods.

Telemedicine visits. Video or telephone visits are really useful for girls looking for advice and a prescription for contraception or for menopausal symptoms.

Postponed. Average-risk women looking for routine check-ups are advised to postpone doctor visits until after COVID. Other situations wherein postponement must be considered include:

  • For patients with abnormal cervical cancer Screening results, ACOG suggests that Colposcopy In patients with low-grade test results, cervical biopsy testing will be delayed for 6-12 months. In patients with high-grade results, nonetheless, ACOG recommends performing the test inside 3 months.

  • For women who want to stop using contraceptives, ACOG recommends delaying the removal of IUDs and implants if possible. These women must be counseled regarding the prolonged use of those devices.

ACOG emphasizes that decisions regarding outpatient gynecology must be made on a person basis and will keep in mind issues reminiscent of availability of local and regional resources, staffing, personal protective equipment, and the local prevalence of COVID-19.

As a gynecologist specializing in outpatient care, I’m confident that many physicians will welcome these ACOG guidelines as they assist us provide optimal care during these difficult times.