COVID-19 and pregnancy

I have been receiving numerous messages from my pregnant patients and I believe this needs to be addressed swiftly.

COVID-19 is spreading at an alarming rate globally. Even though this rate is alarming, what people need to know is that the mortality rate is extremely low — that is, the chances of dying from the disease are very low especially in healthy people.

What do we know about COVID-19 and pregnancy?

At this time, very little is known about COVID-19, particularly related to its effect on pregnant women and infants and there currently are no recommendations specific to pregnant women regarding the evaluation or management of COVID-19.

Based on limited data from previous coronaviruses (SARS AND MERS) and a small amount of the COVID-19 cases, it is believed that pregnant women may be at higher risk of severe illness, morbidity and mortality compared with the general population (one to three per cent). However, this data is limited and we are unsure if these outcomes were against the background of predisposed maternal infection.

Currently, it is unclear if COVID-19 can pass the placenta and enter the foetus’ blood stream. There have been reports of newborns being tested positive for COVID-19, but validated data needs to confirm how they were infected and if it crossed the placental membrane. In limited recent cases of infants born to mothers infected with COVID-19 published in the peer-reviewed literature, none of the infants have tested positive for COVID-19.

Recommendations

•OBGYNS should obtain a detailed travel history for pregnant patients presenting with fever and acute respiratory illness.

•OBGYNS should notify infection control.

•Patients with symptoms should not appear at their health care facility unannounced.

•Suspected or known patients who require admission should be placed in an infection isolation room.

•Infants born to suspected or confirmed mothers should be placed in isolation until both mother and infant are proven to be negative for COVID-19.

•Breastfeeding — it is unknown at this time if breastfeeding is safe in mothers who are positive for COVID-19. Mothers who are positive and who wish to breastfeed should take the necessary precautions, including washing hands before and after breastfeeding and wearing a face mask whilst breastfeeding.

•Mothers who are positive for the virus can also take same precautions for expressing milk and encourage healthy family members to feed the infants with the bottle.

•Avoid non essential travel and travel to restricted countries.

•Mothers are encouraged to take their prenatals in a timely manner, as well as other necessary vitamins.

There is still not much that is known about COVID-19 and pregnancy, but pregnant women should be in close communication with their doctors. Remember that even in pregnancy, the virus can still be mild, and to date there have been no maternal or infant deaths reported.

Remain calm at all times and please do not panic!

Dr Daryl Daley is a cosmetic gynaecologist and obstetrician operating from Gynae Associates, 23 Tangerine Place, Kingston 10. Follow him on Instagram @drdaryldaleyobgyn or phone 876-929-6038/9.