In light of difficult situations like the one we are presently living in, the Ministry of Public Health issues some recommendations for care during pregnancy. We also encourage the use of condoms to avoid ZIKA and other sexually transmitted diseases.
An important factor to transmit to women who feel concerned is that, “there has been no description of the virus transmission from mother to child (vertical transmission), and neither through maternal milk. Social distancing is the rule”, expressed by Patricia Veiluva, Director of Ministry Health Programs. Also emphasizing that all pregnant women and their partners should take the same precaution measures as everybody else to avoid the infection by COVID-19.
Has the present sanitary emergency affected prenatal care in hospitals?
They should not be affected, since they are essential services which cannot go a miss, there may have been some deficiencies initially, however there should be no lack of services.
In Paraguay have there been no registered cases of pregnant women with COVID-19?
To date, there are no cases of coronavirus among pregnant women, there where two suspected cases which were negative.
What are the recommendations for pregnant women at this moment?
We urge prenatal control to be spaced out as much as possible, and that each consultancy be good quality in order to reduce unnecessary visits, except in cases of patients with risk factors such as hypertension, diabetes or any other maternal condition in which the doctor considers it necessary for more frequent visits. The ideal is to limit to four prenatal visits.
If risk factors are identified, they should attend the consultancy proposed by the health professional. When attending the health service, all precautions must be taken, communicating to the health professionals if the patient had or has any symptoms such as a fever, cough, difficulty breathing or feeling flu-like symptoms, in order to be channelled to the respiratory diseases service. We urge the patient to go to the health centre alone, not accompanied so as to minimize accumulation of people in the corridors and also to take advantage of the visit in the most efficient manner and take all the necessary studies.
As with the general population, the message is to comply with the social isolation, measures of social distancing are indispensable. If it is necessary to go out keep a distance with other people, wash your hands, use alcohol gel and avoid agglomerations.
The partnership between the Foundation and the District Hospital of Lambaré began with great enthusiasm, being the third Ministry of Health Public Hospital to join the Challenge. Approximately 8.000 pregnant women attend the hospital per annum, of which 2.000 are estimated to be at high risk of developing preeclampsia.
On the 20th of February, the first prenatal consultations took place in the Preeclampsia Challenge Program, with the previous theoretical and practical training sessions of doctors, midwives and nurses regarding prevention and early detection of preeclampsia. The arrival and initial implementation of the Preeclampsia Challenge involved a change in paradigms for the health professionals on many levels. Health professionals took advantage, in a positive manner, of the new partnership to manage together with the hospital authorities, the renovation of the consultancy and waiting room for pregnant patients. The Hospital achieved a modern and remodelled prenatal care area with excellent facilities. In spite of the lack of resources public health centres usually have, the team of health professionals proved to be good articulators and the project initiated successfully. The city of Lambaré has a large population of approximately 180.000 inhabitants. The hospital also receives patients from other cities and nearby districts.
Regarding the adolescence project, visits to Family Units in the Capital and Central region have proved to be of vital importance for capacity building of health professionals working in these regions; since achieving close communication between family units and their reference hospitals still remains a challenge. On the other hand, during the visits the high demand for information regarding sub dermic implants emerged, highlighting the need for opportune and appropriate counselling to adolescents who attend these community services.
The objective is to reach the health centres soon with the collaboration which the Foundation offers in the areas of preeclampsia and adolescence.
The Coordinators of the Preeclampsia Challenge and Adolescence, along with their medical advisors travelled to the region of Alto Paraná during the month of February to conduct technical visits to the hospitals and family health care units where the Foundation expects to extend its collaboration. Meetings were established with reference staff from the health centres and regional authorities. The presentation of the Preeclampsia Challenge and the adolescence program took place. Regarding the Preeclampsia Challenge, relevant epidemiological data of the region was collected. According to 2019 data, there were 8.000 births in the Ministry Public Health Care in the Alto Paraná region, of which 200 pregnancies suffered from preeclampsia and 60 suffered eclampsia. The prevalence of preeclampsia in the region is, approximately 2,5%, which reflects a high degree of underreporting according to regional authorities.
Despite the fact that Alto Paraná is fast-growing and the X Region counts on the cooperation of Itaipú and the Inter-American Development Bank to improve health centres in the region, there are still many lives lost for preventative causes, as are the cases of preeclampsia. For this reason, the foundations collaboration on health professional’s capacity building will make a great impact in the joint effort of substantially reducing maternal and perinatal complications and deaths due to preeclampsia.
According to the agreement reached between the foundations technical team and the regional health authorities, it is expected to reach 250 doctors and 600 midwives and nurses through prevention and early detection of PE training.
Regarding the adolescence program, likewise visits to hospitals took place: to the Regional Hospital of Ciudad del Este, the Regional Hospital of Presidente Franco, the Regional Hospital of Minga Guazú, and also Family Units Km 7 Monday, Ciudad Nueva, and the X Sanitary Region.
Currently there are only two adolescent units and the demand is high. The foundations collaboration will focus firstly on training health professionals on appropriate care for adolescents. Secondly, it will focus on long term family planning methods and counselling for adolescents at risk of unintended pregnancies. During this year, the projection is to reach 400 professionals from different hospitals and health care units in the region. According to the Ministry of Health guidelines, once the sanitary emergency we are in is overcome and the quarantine is lifted, all Foundations activities will be resumed in order to fulfil its 2020 objectives.