[Adaptation of Health Care Organization in a level III Maternity Hospital during the COVID-19 pandemic].

The COVID-19 pandemic required a rapid adaptation of health care organization. The objective was to ensure the care of patients avoiding contamination at the time of delivery and for the nursing staff. The establishment of parent-child essential links beyond the pandemic was also taken into account. The reorganization of care first relied upon the constitution of a multidisciplinary operational team which allowed for efficient responsiveness. Then, the activities were refocused on the epidemic situation with the deprogramming of non-urgent activities and the articulation with the ambulatory network. A reorganization of the schedules and a specific training in dressing were carried out. The supply of surgical masks, disinfectant gels and wipes has been provided. A triage of admissions was set up with a special circuit and dedicated staff. A specific delivery room and operating theater equipped with strictly essential materials have been associated with a specific neonatal resuscitation station. In neonatology, two sectors where positive pressure has been suspended have been dedicated to families at risk. Wearing a mask and washing hands with disinfection with hydroalcoholic gel was required for all patients. The children were left at their mothers' bedside in a private room. An incentive for breastfeeding was made. Early discharge from 48 hours was systematically organized with relay by midwife at home. In conclusion, this adaptation of the organization of care has made it possible to respond satisfactorily to the specific situation of this pandemic.