Coronavirus during pregnancy: prevention and treatment
Dr. Ángel Lorenzo Álvarez of the Women's Unit analyzes the possible consequences of the Coronavirus during pregnancy and after childbirth as of March 10, 2020 (updated July 2021).
The first case of Coronavirus began in Wuhan, China, presenting with fever, dry cough, and shortness of breath on December 8, 2019. In early January 2020, it was identified that this respiratory outbreak was due to a new coronavirus, SARS-CoV-2. The disease it causes is called COVID-19.
General information about the Coronavirus
With the data we have:
- The period of incubation es of 5 days (ranging from 2 to 14 days).
- The disease mainly affects people between 30 and 79 years old, being very rare in people under 20 years of age.
- The mortality rate is around 2%, with higher figures in China.
The World Health Organization ( WHO ) provides information daily on its website.
- 80% of patients present mild symptoms and the other 20% present more severe symptoms.
- This 20% is usually made up of patients with underlying medical conditions such as high blood pressure, cardiovascular disease, diabetes, or respiratory illnesses.
The Ministry of Health also publishes the current situation on its website.
How it is transmitted
The infection originated in animals and has spread to humans, but the exact source of infection is unknown. Transmission has been demonstrated through respiratory droplets and direct contact with respiratory secretions from coughing and sneezing at a distance of less than 2 meters. It is unclear whether it can also be transmitted through contact with contaminated objects.
Symptom
The infection can range from asymptomatic to causing serious respiratory problems and even death.
COVID-19 can manifest with symptoms similar to a common cold, progress to severe respiratory failure, and even death.
Patients typically present with fever, cough, muscle aches, headache, and diarrhea.
The most frequent complication is pneumonia.
Coronavirus during pregnancy
It appears that pregnant women are not more susceptible to Coronavirus infection. Although the absolute risk of severe Coronavirus during pregnancy remains low, it has now been determined that pregnant women have a higher risk of developing severe COVID-19 compared to non-pregnant women, particularly in the third trimester.
Regarding complications in newborns , current data do not suggest an increased risk of miscarriage or early pregnancy loss. No birth defects have been reported. The main perinatal complication associated with Coronavirus during pregnancy is prematurity , with rates around 17%, primarily due to involuntary prematurity in cases where the pregnancy must be terminated for the mother's well-being.
How to prevent coronavirus infection during pregnancy
Cleaning and disinfection of surfaces and areas in contact with the patient will be done routinely using a low-concentration sodium hypochlorite (bleach) solution, alcohol, or hydrogen peroxide for one minute.
Disinfectant wipes can be used.
It is recommended during pregnancy:
- Frequent hand washing.
- When coughing or sneezing, cover your nose and mouth with your flexed elbow.
- Avoid touching your eyes, nose, and mouth.
- Use disposable tissues to remove respiratory secretions and throw them away after use.
- Avoid crowds and public transportation.
- Limit social relationships.
- Limit travel to strictly necessary.
It is recommended not to travel to areas where there is community transmission of the virus, which can be consulted at the following link.
Vaccination of pregnant women
Currently, the COVID-19 vaccination strategy in Spain recommends vaccination for pregnant women at any stage of pregnancy, as well as during the postpartum period and while breastfeeding, at the appropriate time according to their priority group. Furthermore, the type of vaccine administered should be mRNA (Commonwealth or Moderna).
This new guideline, approved in June, was established after reviewing data from the U.S. V-Safe Surveillance registry on vaccination safety, corresponding to 35.691 pregnant women who received mRNA doses. According to preliminary data, which followed 3.958 pregnant women (827 of whom had already completed their pregnancy), no significant safety concerns were identified.
Regarding breastfeeding, no vaccine components have been found in breast milk, but antibodies have been found that could be transmitted to the baby.
Furthermore, according to the recommendations of the Federation of Spanish Scientific Medical Associations (FACME), it is not necessary to wait between vaccination and trying to conceive. Nor is it justified to terminate a pregnancy when a woman has been vaccinated without knowing her status, since, according to the data, there is no evidence of harm to the fetus.
What is the treatment for Coronavirus?
Currently, there is no treatment for COVID-19.
Antivirals, corticosteroids, antibiotics - to prevent bacterial superinfection - and heparin - an anticoagulant - are being used.
Coronavirus treatment during pregnancy
In pregnant women , treatment is based on seeking the well-being of both the mother and the fetus and thoroughly monitoring the pregnancy:
- should isolate the patient,
- take samples for the diagnosis of COVID-19 and other viruses,
- administer oxygen if you need it,
- Prevent the appearance of blood clots by administering subcutaneous heparin for at least 10 days
- and else fetal support and monitoring measures in case it is necessary to advance delivery, avoiding skin-to-skin contact.
Treatment of newborns of infected mothers
Care of children born to mothers infected with COVID-19:
- Children born to mothers infected with SARS-CoV-2 should be isolated the rest.
- The child may or may not be with the mother, respecting social distancing, wearing a mask, etc., depending on whether the mother is asymptomatic or not.
- It is unknown whether infected newborns are at increased risk of severe complications.
Article written by Dr. Ángel Lorenzo Álvarez , specialist in Prenatal Diagnosis at the Women's Unit of the Ruber International Hospital.
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If you found this article interesting and would like to be seen by an obstetrics professional, the Women's Unit at Ruber International Hospital is an international leader in this field. You can request more information by calling 917303673, schedule an in-person appointment , or book an online consultation if you prefer; always with top specialists.