The midday sun penetrates the doctors’ room. Senior obstetrician Marina Maklakova, with syringes and saline in her hand, enters the room, then puts them on the table. At first he refuses to speak, he says that it is the job of the medical staff to help, they have done their job. He will be in 2020 ․ She spent 60 days in the “COVID-19” department of the maternity hospital, when many people were just afraid to communicate with people infected with the coronavirus. “60 cruel and hard days,” Marina Maklakova is silent after saying this, and it seems that the hard feelings of those days are filled with silence. And although the face is covered with a mask, the excitement is noticeable in the eyes.
2020 On March 30, 2012, the first pregnant woman with COVID-19 was admitted to the Republican Institute of Reproductive Health, Perinatology, Obstetrics and Gynecology (VAPMGI, popularly known as the Republican Maternity Hospital) with her children aged 6 and 4. Many employees might not have imagined at the time that the COVID-19 department would soon open on the third floor of the new hospital building, which was commissioned in 2019, and would be the only one in the country to receive pregnant women diagnosed with the new disease and obstetric problems. as well as pregnant women who do not have obstetric problems but are 38 weeks and older and have been at least in contact (since April 2020 by the order of the Minister of HealthPregnant women and newborns who have been registered with COVID-19, but whose complaints and complications are not of obstetric nature, are referred to St. Gregory the Illuminator Medical Center.
Various warning signs were to appear on the doors of the new ward, such as “entry of outsiders is strictly forbidden”, “entry only in protective clothing”, “infected area”. The diagnosed pregnant women were not only isolated, but also their movement, visitation and guardianship were prohibited. At first, most of the medical staff refused to come here, and even the ward staff began to be wary.
During the regular council, a question was raised as to who was ready to go to work in the “COVID-19” department. Marina Maklakova, a senior midwife at the Conservative Gynecology Department, seeing the overwhelming silence, offered to transfer her to the newly opened department. “The human factor was the first thing I agreed to do in your department, so that our middle-aged staff would not take risks, because many people were afraid, did not know what the disease was, what the consequences could be,” he says. And obstetrician-gynecologist Vruyr Grigoryan was the first doctor to work alone in the department for months.
Coveid ward operating room
The first flow of pregnant women with Covid was relatively light, but then it got worse, the cases of pneumonia increased. Marina remembers that one of the hospitals in the capital admitted a pregnant woman with bilateral pneumonia who was in a very serious condition, who also had obstetric problems. After giving birth, he was taken to St. Gregory the Illuminator Hospital, where his wife died 2-3 days later. “It was one of the cruel days. The baby was born, but the mother died. 2020 It was in May, ”the midwife’s eyes got wet after saying this, and her voice trembled noticeably.
Maternal deaths with Covid have not been registered in VAPMHI so far.
In the womb of the maternity ward
During the first months, it was very difficult to work with pregnant women. Not only did they have obstetric problems, lung disease, or other symptoms of covidium, but they were also more emotional, which could often lead to stressful situations. In that case, the medical staff also played the role of a psychologist, calming the pregnant women, reminding them that when the swine flu broke out, there were deaths again, but the infection receded and the situation was overcome.
The birthplace of the isolator
Obstetrician Marina Maklakova remembers that there were days when she sat next to a pregnant woman with a cow. But after 60 days it was already physically difficult to endure such a pace of work.
“It was June 15, I will never forget that day. I could not believe that I was already at home. I missed my parents a lot. “That day and the next day, for two days in a row, I slept, and then I gradually returned to everyday life,” says Marina. To this day, pregnant women who had a baby in those days call the midwife, but now as a relative. Months after a busy work period, Marina also became infected, losing heat, taste and smell, and her sense of smell was restored a year later, and her sense of taste was restored after 7 months.
The head of the “COVID-19” department is currently obstetrician-gynecologist Aghasi Sharbatyan. He says that during the first wave of the epidemic, those who had symptoms were immediately isolated, the same thing was done to the baby after birth to avoid infection. And only a week later the child was handed over to the mother. Later, however, the World Health Organization declared that the infection could not be transmitted through breast milk. Now, if the mother has not had a fever for 3 days and 10 days have passed since the first symptoms, she can keep the baby and feed him.
The newborn is also tested within 24 hours after the mother is diagnosed with Covid. If the test is positive, they do a double test. However, Dr. Sharbatyan says that even if the infection is confirmed, the children do not have any problems.
They had 8 infected newborns during 2020, this year the number of cases has increased to 44, moreover, most of them were in October. According to Sharbatyan, in October-November, another wave of pregnant women with covidium was in their maternity hospital. Now the number of cases has significantly decreased.
This year, from January to December 1, the Republican Institute of Reproductive Health, Perinatology, Obstetrics and Gynecology had 756 pregnant women diagnosed with covid, instead of 665 last year. Dr. Sharbatyan conditioned the increase of cases by not following the rules, not being vaccinated, also by the academic year. In addition, he notices that the virus is characterized by wavy growth.
“Here is a struggle between people and the virus. “We use our weapons against him, and he uses his defensive weapons,” says my interlocutor.
The most difficult days of the “COVID-19” department of the maternity hospital were during the peak of the infection. During the last wave, the number of beds was increased to 100, and at the same time 70-75 patients were pregnant.
When the infection had just spread last year, there were also fears among the medical staff of the maternity hospital. Many did not want to serve in this department, where only a few people could be admitted for a very limited time. During that time, one of the medical staff on the third floor of the maternity hospital was diagnosed with quid, as a result of which the others were isolated as contacts. This was the stage when the contact persons were accommodated in hotels, forbidding them to communicate with the outside world. The isolation of the entire tax staff presupposed busy days of the other colleagues – frequent shifts, a large amount of work.
In the womb of the maternity ward
Sometimes problems arise with relatives of pregnant women, who are often skeptical that the pregnant woman is ill. There was a case when a pregnant woman, who also had an obstetric problem, refused treatment and went home, but two days later appeared in a serious condition in the hospital. Dr. Sharbatyan says that there are cases when a woman can be well at that moment, but after a few days the condition may worsen, and the relatives blame the medical staff for that. The doctor conditions such a process with the peculiarity of “COVID-19”. “In any case, that approach of the relatives keeps us tense,” my interlocutor notes.
This year, according to him, the number of recurrent cases has also increased. For example, he says, last year a woman gave birth with a dowry, this year she came to give birth again with a dowry.
Nazeli Davtyan, a senior midwife at Gnaran (the department where natural childbirth is performed), says that the work in the COVID-19 department is several times more than in other departments: there are many examinations and procedures, and pregnant women are more emotional and vulnerable. Davtyan also worked in this department in parallel during the summer months of this year. He notices that the medical staff has gradually adapted to the infection, some of them have been infected and treated. “The public does not know 10% of the hard work that is being done. “Few people know about the psychological state of both the patient and the medical worker that we are able to overcome,” he notes.
Midwife Susanna Mirakhoryan replaced her colleague Flora Gharibyan in the “COVID-19” department, who worked and lived there for exactly 3 months. On the day of our visit, the latter could not be met. Now they both work in the same department. It was already difficult for Flora to work 90 days and nights, so a meeting was called to find a replacement. Susanna had agreed, especially, she says, she had taken you to her before and she was not afraid.
Dr. Aghasi Sharbatyan remembers that for some time even the mothers did not enter this department, it was a risky job. And in many cases, even the household chores, starting with dumping garbage, were done by the doctors working here, with whom they were afraid to communicate in other departments. One of those doctors was the epidemiologist of the hospital Albina Avetisyan. Sharbatyan says that regardless of everything, it was a job, they had to do it, and there were cases when he forgot to even wear a mask while receiving first aid.
Kristine Gasparyan is 35 years old. The day before our visit, his third child, Eve, was born. The baby weighing 2.3 kg and 48 cm tall was born a little earlier than planned. The mother jokes that she is a tall and thin girl. The birth was accepted by Dr. Sharbatyan.
Christine was taken to the Republican Maternity Hospital on the night of November 26 from Vanadzor. She says that after knowing the positive result of the cow test, she started crying and also had an obstetric problem. He says that his 6-year-old daughter probably infected him because he did not leave the house. The girl had come home from school with a fever, had been taken to a doctor, and had been given medication. The next day, Christine had a fever, severe muscle aches, and weakness.
All the pregnant women we met in the department assume that they were infected from the family, because they did not leave the house during that time.
Mariam Ghazaryan came from Vardenis. The same story is in her case: the girl came home from school with a fever, after that she had a fever and a cough. Her daughter’s test was negative, she was positive. He says that from the beginning he was more excited that he had to leave his two children and come to Yerevan. During this time the children are taken care of by the husband.
Mary Tadevosyan from Yeghvard is expecting her first child. He says he did not leave the house. The husband’s mother also has covidium, she has bilateral pneumonia. According to Mary, she became infected after the second vaccination. Now the mother-in-law is receiving treatment at home.
In the case of Susanna Tigranyan, the story is almost the same. He is from Vedi. 2020 He was infected in July and was taken very seriously. “It started with a stomach ache, then weakness, terrible sweating, loss of smell, I did not eat for a long time. “I thought I would not get infected again,” he says. He had fever, leg pain, weakness from the second infection. Now all that is over, Susanna smiles and says it is already good.
When talking to “COVID-19” and women with obstetric problems, it is noticeable that everyone seems to have the same worries, which is natural. “Once your test was approved, we became more concerned about the baby,” they say.
Koryun Karagulyan, a doctor in charge of the neonatal resuscitation and intensive care unit, says that infected infants are not usually brought to their ward, they live together with their mothers. The doctor notes that most of the children’s test results are negative, it is rarely passed from mother to child.
The medical staff of the maternity hospital, which has been fighting against this disease for more than 1.5 years, is doing invisible work for those outside the walls of the building.
ՀԳ․ During the publication of the article, we learned that Mary Tadevosyan had a daughter.
Photos by Hakob Poghosyan
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