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 It began in Wuhan (China) with a 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 caused 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.
World Health Organization (OMS) offers daily information 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.
El Ministry of Health also publishes the current situation on its website.
How it is transmitted
The infection has Animal origin, having passed to humans, but the exact source of infection is unknown. Infection 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 be from asymptomatic to the point of causing serious respiratory problems and even death.
COVID-19 can manifest with symptoms similar to a common cold up to a picture of severe respiratory failure and even death.
Patients usually present fever, cough, muscle aches, headache and diarrhea.
The most common complication is pneumonia.
Coronavirus during pregnancy
It seems that pregnant women are not more susceptible of becoming infected with Coronavirus. Although the absolute risk of increased severity of Coronavirus during pregnancy remains low, it has now been determined that pregnant women have a increased risk of serious illness associated with COVID-19 compared to non-pregnant women, especially 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 described. The main perinatal complication associated with Coronavirus during pregnancy is prematurity, with rates around 17%, mainly due to forced prematurity in those cases where pregnancy must be terminated for the good of the mother.
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 and may be consulted. In the following link.
Vaccination of pregnant women
Currently, the COVID-19 Vaccination Strategy . recommends vaccination of pregnant women, at any time during pregnancy, as well as during the postpartum period and during breastfeeding, at the time that corresponds to you according to your prioritization group. In addition, the type of vaccine administered must be mRNA (Comirnaty 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?
At present, there is no treatment against COVID-19.
Antivirals, corticosteroids, antibiotics - to prevent bacterial superinfection - and heparin - an anticoagulant - are being used.
Coronavirus treatment during pregnancy
in pregnant women, the treatment is based on seeking the well-being of both the mother and the fetus and monitoring the pregnancy exhaustively:
- 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 infected mothers due to 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 the Dr. Ángel Lorenzo Álvarez, Prenatal Diagnosis specialist at the Women's Unit of the Ruber International Hospital.
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If you were interested in this article and would like to be seen by an obstetrician, the Women's Unit at Ruber International Hospital is an international leader in this field. You can request more information by calling 917303673. make an appointment for an in-person consultation or make an appointment for an online consultation if you prefer the remote option; always with the best specialists.