With the new Coronavirus (hereafter termed COVID-19) cases hitting more than 100 countries to date, a few days ago, the WHO declared this infection a pandemic. The first case was reported to have occurred in November last year, according to the Chinese government documents in Hubei city, Wuhan province and has hit more than 23 million people. The youngest patient was an infant at 36 hours following delivery, the good news is, that, there isn’t any pregnancy-related adverse outcome that is directly attributable to COVID-19.
Today’s article answers a million-dollar question; Is there a need to worry if a pregnant woman contracts COVID-19? Let’s get started.
We make a diagnosis of COVID-19 basing on;
– exposure from a COVID-19 hit nation or any close contact with a person who has tested positive for COVID-19,
-characteristic Computed tomography (CT) scan findings
– and a positive COVID-19 test.
The COVID-19 test is a quantitative reverse transcription-polymerase chain reaction analysis.
Due to the physiological changes that occur, pregnancy predisposes women to viral infections. In 2009, during the outbreak of the Influenza A subtype H1N1 virus, 1% of the people infected were pregnant women. Pregnant women, however, contributed to 5% of the deaths that occurred due to this virus.
Two other epidemics have occurred involving the coronaviruses and these include;
-Severe Acute Respiratory Syndrome (SARS-CoV) and
-Middle East Respiratory Syndrome (MERS-CoV).
These posed a significant threat to the pregnancy.
Data is not readily available regarding the effect of COVID-19 on pregnancy and the neonate. It is unknown whether COVID-19 crosses the placenta to enter the foetus or not. It is because all the pregnant women who have contracted COVID-19 were in their late second or third trimester. And there’s no conclusive evidence that the youngest patient, an infant diagnosed with the viral infection at 36 hours, actually contracted it from the mother during delivery.
COVID-19 in pregnancy is a relatively less severe disease, presenting mainly with fever and cough. Other notable symptoms include; muscle aches (myalgia), body weakness (malaise), shortness of breath, sore throat and diarrhoea. Many patients have a low lymphocyte count (lymphopenia), increased C-reactive protein and ground-glass shadows in the lungs on the CT scan.
Two case series involving pregnant women reported foetal distress and premature rupture of membranes in 2 in 9 patients in each of the studies, but no woman died. Another study had similar findings: One woman developed acute respiratory distress syndrome that needed intensive care unit and ventilation. She was diagnosed with COVID-19 on her second day following delivery.
Read this article: COVID-19: Wash your hands, exercise social distancing.
Chen et al. reported no neonatal complications attributable to COVID-19 in their study, and no infant acquired COVID-19. It is not because COVID-19 does not appear in breast milk – the data for or against this argument is not available to date. It is because there are protocols set in place to isolate any newborn baby from their mother for 14 days after delivery and no breastfeeding during this period. They can only be reunited once the clinical team clears their safety to stay together: the mother initiates breastfeeding.
No data reports complications like intrauterine growth restriction of the fetus, miscarriage, congenital anomalies or preterm birth if a pregnant woman contracts COVID-19 during the first or early second trimester.
It is particularly important to note, that since COVID-19 is highly contagious, the health care team strictly follows the infection prevention and control guidelines. The team must apply the national guidelines are whenever a pregnant woman is either suspected of having COVID-19 or confirmed to have it when she is in labour. The safety of both the unborn baby and the health care providers should be a matter of everyone’s interest.
All the pregnant women reported in the few available studies delivered through Caesarean section – the mode of delivery should not be based on the COVID-19 serology of the woman, but rather according to the national obstetric practice guidelines.
The effects posed by the virus to the pregnant woman are unknown due to the limited data that is available to date. The virus seems to cause a less severe threat when compared to either SARS-CoV or MERS-CoV. Defer all nonessential travels or any social gatherings whatsoever. Every life matters as the different countries tackle the pandemic.
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