Antenatal care or pregnancy care in the COVID pandemic

The COVID-19 pandemic has everyone anxious and in fear. If you are pregnant, undoubtedly you have a lot of queries about whether coronavirus poses a threat to you and your baby. The answers are not crystal clear yet, due to the evolving nature of the disease. Knowledge from past epidemics due to similar respiratory illnesses help understand and manage viral infections during pregnancy. Here are the common queries among pregnant women answered.

What effect does coronavirus have on pregnant women?

Generally, pregnant women do not appear to be more risky than healthy adults to develop a more serious disease or any complications if affected by coronavirus. Mostly, they will only experience mild to moderate flu-like symptoms.

If you are pregnant and your flu-like symptoms are getting worse, it could mean that your chest infection is getting more severe, and you may require hospitalization. If you develop more severe symptoms or your recovery is getting delayed, contact a first response hospital near you immediately.

What effect will coronavirus have on my baby if I test positive for COVID-19?

As this is a very new virus, all the information and evidence is still not available to us. There is no evidence to suggest an increased risk of miscarriage if exposed to COVID-19. There is also no evidence of vertical transmission, which refers to the ability of the virus to pass to your unborn baby during pregnancy.
In a study of nine pregnant women in China who tested positive for COVID-19, all nine babies tested negative for the virus and were healthy overall. One pregnant lady in London tested positive for coronavirus and later her newborn also tested positive. However, it is unclear whether the baby contracted the viral infection in utero or shortly after birth. Expert opinion is that the baby is unlikely to be exposed during pregnancy, and it is unlikely for the baby to have any defects in development as a result. As of now, there isn’t any new evidence that says otherwise.

What are the effects of Coronavirus in the first trimester?

Pregnant women who were part of The Lancet study were all in their second or third trimesters. There is still no data on pregnant women who tested positive for the virus in their first trimester. Patients who may get infected with symptoms like high fever may increase the risk of birth defects, though there is no evidence for this yet.

Are pregnant women a vulnerable group for Coronavirus?

It is not yet known if pregnant women are more susceptible to be infected by COVID-19 when compared to the normal population. Despite this, pregnant women are advised to reduce social contact by social distancing. It is an established fact that in some women, pregnancy alters how the body fights some viral infections. Though evidence for coronavirus is still insufficient, it is for this reason that pregnant women are advised to be extra cautious during this pandemic.

Will I be able to breastfeed my baby if I have suspected or confirmed coronavirus?

Yes. The benefits of breastfeeding your infant far outweigh the risk of transmission of coronavirus through breastmilk. The main risk of breastfeeding is due to the close contact between you and your baby which can pose a risk of droplet infection that can spread to the baby while breathing. Discuss the risks and benefits with your treating doctor and family before you make a decision.

Here are some steps to follow to minimize the risk of transmission:

• Wash your hands before feeding or touching the baby, breast pump or bottles
• Try to avoid coughing or sneezing while you feed
• Wear a face mask while feeding, if available.
• If you are using a breast pump, follow instructions for cleaning and sterilizing properly.
• Consider asking one of your healthy family members to feed your baby if you are expressing milk.

Precautions for pregnant women against Coronavirus

Here are some actions you can take to prevent getting the disease during pregnancy:

• Wash your hands frequently. Hand hygiene can really protect you from exposure to COVID-19. You may hear this over and over but with good reason.
• Practice social distancing. Always maintain a distance of at least 2 metres or 6 feet from others when you are in a public place. Avoid contact with others as much as possible.
• Get your flu vaccination on time. Though the flu vaccine does not protect you from exposure to COVID-19, it does make you less susceptible to influenza, which can cause complications during pregnancy.
• Use a tissue when you cough or sneeze, throw the tissue in the dustbin. Wash your hands right after.
• Do not ignore any respiratory symptoms. If you develop a cough or any respiratory distress, do not hesitate to call your doctor. After taking a detailed history, your doctor will decide if you need to get tested for COVID-19.
• Go virtual. As much as possible, consider virtual consultations instead of prenatal visits to your gynecologist. Try to minimize or altogether avoid spending time in the doctors waiting room or in the hospital. However, some tests will require you to be there in person such as the ultrasound, blood tests and fetal testing.
• Work from home whenever possible.
• Stay safe. Symptoms such as high fever with or without continuous cough may indicate a possible coronavirus infection. Avoid coming in close contact with anyone showing these symptoms & take the time to look for support from your family and friends. Keep in touch via emails, messages or video chats. Consider taking up a new hobby or acquiring a new skill. Do things that make you happy and put your mind at ease such as taking a long shower, meditating or reading a book. Exercise as per your doctor’s advice and regularly do your Kegels and squats as recommended.

Do not stress too much if your due date is nearing, as hospitals have a system in place for safe deliveries and to ensure minimal risk of exposure for newborns.

Dr. Ruchi Tandon is a reputed Gynecologist practicing in leading hospitals in South Delhi namely Max and Apollo hospitals with over 14 years of experience in handling all kinds of pregnancies. She is known for her bedside manners and etiquette towards pregnant women.

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