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COVID-19: GYN Guidelines
CMECNE

Abnormal Pap/HPV Report During COVID-19 Pandemic? Interim Guidance from ASCCP

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Learning Objectives and CME/Disclosure Information

This activity is intended for healthcare providers delivering care to women and their families.

After completing this activity, the participant should be better able to:

1. Discuss the reasoning behind modifying gynecologic practice during the COVID-19 pandemic
2. Describe changes to the ASCCP standards for management and follow-up of abnormal cervical cancer screening results

Estimated time to complete activity: 0.25 hours

Faculty:

Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.

Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.

Method of Participation and Request for Credit

Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from through , participants must read the learning objectives and faculty disclosures and study the educational activity.

If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.

For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.

Read Disclaimer & Fine Print

NOTE: Information and guidelines may change rapidly. Check in with listed references in ‘Learn More – Primary Sources’ to best keep up to date

SUMMARY:

ACOG and other societies have recommended modification of gynecologic office visits and surgical procedures during the COVID-19 pandemic. The primary goals are to protect patient health and also limit viral transmission to professional and office staff. ASCCP provides recommendations specific to the management of abnormal cervical cancer screening tests and provides the following guidance

If Practicing in a Setting Where Elective Procedures Have been Suspended

  • Low-grade cervical cancer screening result
    • May postpone diagnostic evaluation up to 6 to 12 months
  • High-grade cervical cancer screening result
    • Document attempts to contact and schedule diagnostic evaluation within 3 months

KEY POINTS:

  • High-grade cervical disease without suspected invasive disease
    • Document attempts to contact and schedule procedure within 3 months
  • With suspected invasive disease
    • Attempt contact within 2 weeks
    • Evaluate within 2 weeks of that contact (i.e., 4 weeks from the initial report or referral)

ADDITIONAL NOTES:

  • ASCCP states that the above should not be considered “definitive management guidelines”, but rather management should take into account the clinical scenario and review “case-by-case”
  • Guidelines may change due to current “fluidity of the healthcare environment”
  • Tracking protocols are still necessary so that when routine care is reinstated, patients can be traced and called back for care
  • The guideline further states that ASCCP Colposcopy Standards should be used once the pandemic is contained (see ‘Learn More – Primary Sources’ below for Colposcopy Standards)

Learn More – Primary Sources:

ASCCP Interim Guidance for Timing of Diagnostic and Treatment Procedures for Patients with Abnormal Cervical Screening Tests

ASCCP Colposcopy Standards

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ACOG COVID-19 FAQs for Gynecologic Care
COVID-19 Guidance: Key Highlights for Healthcare Professionals
COVID-19 and NSAIDs: Is There Reason for Concern with Use of Ibuprofen?

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Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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