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COVID-19 and Pregnancy

Coronaviruses are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). A novel coronavirus (COVID-19) is a new strain that has not been previously identified in humans.

The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The outbreak was first identified in Wuhan, China and was then declared a pandemic by the World Health Organization (WHO).

Transmission
People can catch COVID-19 from other people who have the virus through small droplets from the nose or mouth, which are spread when an infected person coughs, sneezes, or exhales. These droplets may land of objects or surfaces that an uninfected person touches, and that person then touches their eyes, nose, or mouth. People can also breathe in the droplets from a person who is sick.
The most common symptoms of COVID-19 are fever, tiredness, and dry cough, making it somewhat similar to the flu. A fever is present in 83% of cases that present to hospital, 82% present with dry cough, 31% present with difficulty breathing, 11% present with body aches, 5% present with sore throat, and only 4% present with a runny nose. Severe infection can lead to lung inflammation, respiratory failure, and even death.

Currently there is no evidence that a pregnant woman infected with COVID-19 will display different, or more severe, symptoms from other people. Nor is there evidence that pregnant women are more susceptible to the infection. Furthermore, there has been no indication that COVID-19 can be transmitted from a pregnant mother to her baby in utero as the virus was not found in the placenta, umbilical cord, vagina, breast milk, or even the baby’s throat and nose after birth. However, there is limited information at the moment about COVID-19 and pregnancy and the impact on pregnancy and birth is not fully known.
  1. Is a pregnant woman more susceptible to contracting COVID-19 than the general public?
    • There is no evidence that pregnant women are more likely to become infected with COVID-19 than the general public.
    • From the reports out of China, there were 38 pregnant women infected with COVID-19 and all have mild symptoms. There were no deaths.
  2. What type of contact is considered high-risk for contracting COVID-19?
    • Close contact (a distance of less than one meter for more than five minutes) with an infected patient without wearing an personal protective equipment (PPE).
    • Sharing a closed space, like an air-conditioned room or a space with poor ventilation, with an infected patient and being less than one meter away from them for more than 15 minutes.
  3. How should a pregnant woman protect herself from COVID-19?
    • The same principles for prevention that apply to the general public applies to pregnant women as well:
      • Wash hands frequently with soap and water or use an alcohol-based hand gel if you can’t access soap and water right away.
      • Avoid closed and crowded spaces and if it’s necessary to move about, keep a distance of at least 1.5 meters from other people.
      • Avoid touching your face, especially eyes, nose and mouth.
      • Wear a mask when you are outside your home.
      • When coughing or sneezing, do so into your elbow or cover your nose/mouth with a tissue and throw it away immediately.
  4. Should a pregnant woman be tested for COVID-19?
    • If you have symptoms, such as fever, coughing, difficulty breathing, sore throat, and/or runny nose, please see a doctor immediately. The doctor will determine if you need to be tested for COVID-19.
    • If you have no symptoms, but have other risk factors, please discuss these with your doctor. They will determine if you should be tested.
  5. Where can you be tested for COVID-19?
    • At large public or private hospitals.
    • The test involves swabbing the nose and throat and testing the sample.
  6. If a pregnant woman is infected with COVID-19 will it affect the baby?
    • From the limited evidence available from 38 pregnant women in China infected with COVID-19, none of their babies were born infected.
    • The virus was not found in the amniotic fluid. placenta, umbilical cord, or breast milk.
  7. If a pregnant woman is infected with COVID-19, how will she be cared for during pregnancy?
    • The same prenatal care will be provided as that for an uninfected woman, but if a pregnant woman is infected with COVID-19, she must be quarantined in isolation at the hospital for at least 14 days or until she no longer tests positive for the virus.
    • Breastfeeding if the mother is infected with COVID-19 or is a person under investigation (PUI)
      • Due to the many unknown factors around this infection, for the safety of the baby, it is recommended that the mother pump breast milk for the baby until she is no longer infected. She should wear a mask while pumping, wash her hands with soap and water before and after each pumping session, and carefully sterilize all pump parts after using.
    • The newborn will be bathed as soon as possible after delivery.
      • The newborn will need to be isolated from the mother for at least 14 days or until no infection is found to prevent transmission to the baby.
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    • Will an infected COVID-19 pregnant woman require a Cesarean section?
      • Bumrungrad Hospital’s policy is that any pregnant women infected with COVID-19 or considered a Person Under Investigation (PUI) must deliver through Cesarean section. Spinal anesthesia is offered so she can be awake during the procedure.
    • Newborn care if the mother is infected with COVID-19 or is a person under investigation (PUI)

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