Covid-19 second wave: Precautions for pregnant women

We already know that surviving the deadly coronavirus is difficult and it becomes extremely hard when you are with a child. So, we have some useful notes for all the pregnant women out there. Give a quick read because these are important.

1. Asymptomatic and mild disease during pregnancy-

In more than 95% pregnant women there are no complications except more chances of cesarean delivery and psychological disturbances, anxiety and depression.

Fetus and neonates are not affected approximately 4% to 6% chances of a newborn becoming positive.

Newborn to be isolated from mother but breast feeding to be continued even when mother is positive. Breast milk and skin-to-skin contact are safe in Covid-19 infected mothers if performed with appropriate use of precautions such as hand and breast hygiene and masking.

Also there is no effect on the fetus and mother when mild to moderate Covid infection occurs during early pregnancy. It is not an indication for the medical termination (abortion).

There is no data suggesting vaginal delivery increases chances of neonatal infections.

2. Moderate to severe or acute respiratory disease or patients with comorbidities

Chances of preeclampsia, intrauterine growth retardation and premature delivery increase 4 to 5 times
Chances of fetal or mother’s death increase chances of postpartum hemorrhage and blood transfusion increase if a patient delivers during active Covid infection.

Cesarean section rates are very high to avoid nosocomial infection of newborn and improve perinatal outcome.

Amniotic fluid, placenta, cord blood and newborn blood have 4 to 6% chances of active viral load in all Covid positive mothers.

3. Vaccines for pregnant and lactating mothers are not recommended in India. (Based on how these vaccines work in the body, experts believe they are unlikely to pose a specific risk for people who are pregnant. However, there are currently limited data on the safety of Covid-19 vaccines in pregnant people. Clinical traits that look at the safety and how well the Covid-19 vaccines work in pregnant people are underway or planned. Vaccine manufacturers are also monitoring data from people in the clinical traits who received vaccine and became pregnant. Studies in animals receiving a Moderna, Pfizer-BioNTech or Johnson & Johnson’s Janssen (J&J/Janssen) Covid-19 vaccine before or during pregnancy found no safety concerns.

Protection of Covid affected mother’s antibodies to newborn is not yet confirmed.

Mother’s or child’s blood group relationship with severity of disease not confirmed.

4. Treatment protocol does not change because of pregnancy status.

5. Indirect effects of lockdown or non-availability of doctors or hospital beds have made significant negative impact on ante-natal, intra-natal and post-natal care in many countries resulting in negative outcomes for mother and child as well.

– By Jagdip Shah, M.D., D.G.O. Obstetrician & Gynecologist with 36 years of experience & practicing in Mumbai since 1984.