- Dr. Sima
- by raytcmc
Coronavirus (COVID 19) infection in Pregnancy and Post Partum
The Virus:
Novel Coronavirus (COVID 19) has been identified in Wuhan City, china, The Virus can spread from Person to Person through contaminated droplets and touching of infected surface.
Symptoms: (could be similar to Flu symptoms)
- Fever
- Shortness of Breath
- Cough
- Headache
- Sore throat
- Pneumonia up to Lung Fibrosis
Epidemiology:
The COVID- 19 virus was appearing in Hubei Province in China end of 2019. Since that time there are countries with the highest number of infected persons like USA, Italy, France, Germany and many other countries.
This situation us naturally changing rapidly.
Pregnant women don’t appear to have more consequences of infection COVID 19 than the general population. There are no reported deaths in pregnant women at the moment.
Transmission of mother to Baby:
Expert opinion is the fetus is not exposed during pregnancy.
A case series tested amniotic fluid, placenta swab, cord blood, neonatal throat swab and breast milk samples from COVID 19 infected mother’s were negative for the virus.
Only one case of possible vertical transmission from mother to baby antenatal or intrapartum has been reported in the literature.
Transmission is therefore most likely to be as a neonate. There is no evidence of transmission through genital fluids.
Effect of virus on the mother/ Symptoms:
Symptoms are the same like non pregnant persons
- Mild or moderate cold/flu
- Cough
- Fever
- Shortness of breath
- Pneumonia and hypoxia
At present there is one reported case of pregnant women with COVID-19 who required mechanical ventilation at 30 weeks gestation, following which she had an emergency caesarian section and made a good recovery.
Effect on Fetus:
There are currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19
As there is no evidence of intrauterine fetal infection with COVID-19, so it is therefore no congenital effects of the virus on fetal development.
Advise for pregnant women:
- Self-Isolation
- Avoid travelling
- Attendance for routine antenatal care
- Attendance for unscheduled/urgent antenatal care in women with suspected or confirmed COVID-19.
Postnatal Management
Neonatal Care:
There are limited data to guide the postnatal management for babies or mothers who are positive for COVID-19. There is no evidence at present of antenatal vertical transmission.
All babies of women with suspected or confirmed COVID-19 need to be also tested for COVID-19.
Literature from China has advised separate isolation of the infected mother and her baby for 14 days. However routine precautionary separation of a mother and a healthy baby should not be undertaken lightly.
It is advised that women and healthy infants are kept together in the immediate postpartum period to avoid the potential detrimental effects on feeding and bonding.
Infant Feeding:
In the small number of cases, breast milk was tested, was negative for COVID-19. The main risk for infants or breastfeeding is the close contact with the mother, who is likely to share infectious airborne droplets. In the light of the current evidence, is advisable that the benefits of breastfeeding outweigh any potential risk of transmission of the virus through breast milk.
For women wishing to breastfeed, precautions should be taken to limit viral spread to the baby:
- Hand washing before touching the baby breast pump or bottles
- Wearing a face mask for feeding at the breast
- Follow recommendations for pump cleaning after each use
- Consider asking someone who is well to feed expressed milk to the baby
For women bottle feeding with formula or expressed milk, strict adherence to sterilization guidelines is recommended.
Where mother expressing breast milk in hospital, a dedicated breast pump should be used.
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Dr. Sima Delghandi