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dc.contributor.authorDi Girolamo, Raffaella
dc.contributor.authorKhalil, Asma
dc.contributor.authorRizzo, Giuseppe
dc.contributor.authorCapannolo, Giulia
dc.contributor.authorBuca, Danilo
dc.contributor.authorLiberati, Marco
dc.contributor.authorAcharya, Ganesh
dc.contributor.authorOdibo, Anthony O.
dc.contributor.authorD'Antonio, Francesco
dc.date.accessioned2023-03-09T14:23:03Z
dc.date.available2023-03-09T14:23:03Z
dc.date.issued2022-05-02
dc.description.abstractOBJECTIVE - To systematically identify and critically assess the quality of clinical practice guidelines for the management of SARS-CoV-2 infection in pregnancy.<p> <p>DATA SOURCES - Medline, Scopus, and ISI Web of Science databases were searched until February 15, 2022.<p> <p>STUDY ELIGIBILITY CRITERIA - Inclusion criteria were clinical practice guidelines on the management of SARS-CoV-2 infection in pregnancy. The risk of bias and quality assessments of the included clinical practice guidelines were performed using the Appraisal of Guidelines for REsearch and Evaluation II tool, which is considered the gold standard for quality assessment of clinical practice guidelines. To define a clinical practice guideline as of good quality, we adopted the cutoff score proposed by Amer et al: if the overall clinical practice guideline score was >60%, it was recommended.<p> <p>METHODS - The following clinical points related to the management of pregnant women with SARS-CoV-2 infection were addressed: criteria for maternal hospitalization, recommendations for follow-up fetal growth scan, specific recommendations against invasive procedures, management of labor, timing of delivery, postpartum care, and vaccination strategy.<p> <p>RESULTS - A total of 28 clinical practice guidelines were included. All recommended hospitalization only for severe disease; 46.1% (6/13) suggested a fetal growth scan after SARS-CoV-2 infection, whereas 23.1% (3/13) did not support this practice. Thromboprophylaxis with low-molecular-weight heparin was recommended in symptomatic women by 77.1% (7/9) of the clinical practice guidelines. None of the guidelines recommended administering corticosteroids only for the presence of SARS-CoV-2 infection in preterm gestation, unless specific obstetrical indication exists. Elective induction of labor from 39 weeks of gestation was suggested by 18.1% (2/11) of the clinical practice guidelines included in the present review, whereas 45.4% (5/11) did not recommend elective induction unless other obstetrical indications coexisted. There were 27% (3/11) of clinical practice guidelines that suggested shortening of the second stage of labor, and active pushing was supported by 18.1% (2/11). There was general agreement among the clinical practice guidelines in not recommending cesarean delivery only for the presence of maternal infection and in recommending vaccine boosters at least 6 months after the primary series of vaccination. The Appraisal of Guidelines for REsearch and Evaluation II standardized domain scores for the first overall assessment of clinical practice guidelines had a mean of 50% (standard deviation±21.82%), and 9 clinical practice guidelines scored >60%.<p> <p>CONCLUSION - A significant heterogeneity was found in some of the main aspects of the management of SARS-CoV-2 infection in pregnancy, as reported by the published clinical practice guidelines.en_US
dc.identifier.citationDi Girolamo, Khalil, Rizzo, Capannolo, Buca, Liberati, Acharya, Odibo, D'Antonio. Systematic review and critical evaluation of quality of clinical practice guidelines on the management of SARS-CoV-2 infection in pregnancy. American Journal of Obstetrics & Gynecology MFM (AJOG MFM). 2022;4(5)en_US
dc.identifier.cristinIDFRIDAID 2053800
dc.identifier.doi10.1016/j.ajogmf.2022.100654
dc.identifier.issn2589-9333
dc.identifier.urihttps://hdl.handle.net/10037/28708
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalAmerican Journal of Obstetrics & Gynecology MFM (AJOG MFM)
dc.rights.accessRightsopenAccessen_US
dc.rights.holder© 2022 Elsevier Inc. All rights reserveden_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleSystematic review and critical evaluation of quality of clinical practice guidelines on the management of SARS-CoV-2 infection in pregnancyen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)