COVID-19 and pregnancy: What mothers-to-be need to know

Pregnant women don’t appear to be any sicker than non-pregnant women of the same age. Still, in this report by SADE OGUNTOLA, experts say it is crucial for them to follow the recommended safety precautions to stay safe from COVID-19.

Amid the coronavirus (COVID-19) pandemic, one question that could  be going through the mind of pregnant women is what they should be doing to remain healthy so that they can have a healthy baby.

Certain, there is still much for medical experts to learn about how COVID-19 could cause problems during pregnancy, whether it can be passed to the unborn baby, and how it can affect the health of babies after birth.

But there is concern for women with high-risk pregnancies, including women who have diabetes, hypertension, depression, kidney or lung problems.

“Really a pregnant woman’s risk of developing COVID-19 is not too different from that of another who is not pregnant; both need to take the expected precautions to be protected from this droplet infection,” said Dr Oladipupo Adefuye, the Chief Medical Director (CMD) of the Olabisi Onabanjo Teaching Hospital, Sagamu, Ogun State.

Pregnant women in general experience changes in their bodies that can increase the risk for infection, and with viruses from the same family as COVID-19 and other viral respiratory infections (such as influenza), they may have a higher risk of becoming seriously ill.

It is typical for changes that normally occur in pregnant women to increase their risk of developing respiratory viral infections. Previous outbreaks of different coronaviruses—severe acute respiratory syndrome (SARS) in 2002-2003 and Middle East Respiratory Syndrome (MERS) that began in 2012—increased the risk to pregnant women of having complications including pneumonia, early pregnancy loss, and even death.

Adefuye, a consultant obstetric and gynaecologist, stated that pregnant women need to take precautions such as regular washing of hands, intake of water, eat healthy, plenty of rest, take their prescribed iron tablets, practice social distancing and steer clear of anyone who’s sick.

Dr Adefuye said in ensuring social distancing, antenatal clinic is devoid now of the dancing and singing, so the women are attended to immediately to prevent crowding.

He stated that although pregnant women are now given longer appointments for antenatal care, they should feel free to call the hospital with the phone numbers they were provided to seek help on an emergency.

“They can be appropriately directed on the most appropriate place to be attended to in case there is an emergency or advised on what to do,” he added.

However, since medical experts still have much to learn about how COVID-19 could cause problems during pregnancy and in new babies, he said even during delivery, steps are taken to protect both the mother and her unborn baby from contracting COVID-19.

“They can go through labour normally, but we try to prevent the viral particles coming out from their throat or any unsuspecting medical teams infecting the new baby by making everyone wear a face mask,” he added.

According to Dr Adefuye, although studies are yet to show that the amniotic fluid could also be contaminated with the virus, still precautions are also taken to ensure that the newborn is protected from contracting the virus in its passage through the birth canal.

In addition, surfaces in the labour room, including the floor is decontaminated frequently with water to which bleach has been added.

Dr Habib Sadauki, the vice president, Society of Gynecologists and Obstetrics of Nigeria (SOGON), said COVID -19 in a pregnant woman could be dangerous.

According to him, “there is the risk of stillbirth. The high fever can affect the unborn baby seriously. So, pregnant women should avoid it as much as possible because they are immune-compromised and so susceptible.”

Dr Taiwo Ladipo, incident manager, for the COVID-19 response in Oyo State, however, said that irrespective of the partial lock down, pregnant women should still go for their antenatal care but endeavour to go home early.

To date, there are only a few case reports of pregnancy outcomes following a pregnant woman getting infected with COVID-19. However, prior research on respiratory infections, such as seasonal influenza has indicated that pregnant women, in general, are at higher risk than non-pregnant women for complications from the infection.

It can lead to more common pregnancy complications such as preterm delivery, influenza, gestational hypertension, preeclampsia and gestational diabetes.

To provide clear guidance, SOGON on 27th March published recommendations to maintain the welfare of pregnant women and health works.

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SOGON had advised that medical consultations and advice over telephones should be instituted for non-emergencies to prevent unnecessary hospital visits.

In this respect, it is advised that clinics appointments should be sufficiently spaced to avoid congestion in the outpatients departments to prevent person-to-person coronavirus transmission.

During consultations, health workers are advised to keep a safe distance from the patients and between patients. Also, the application of universal precautions for all infectious diseases is observed at any point in time when the health worker comes close to patients.

The U.K. government recently announced that pregnant women were at an increased risk of severe illness from coronavirus (COVID-19). Speaking at a press conference, Public Health England chief medical officer,Chris Whitty said people over 70, people with underlying health conditions and pregnant women because they fall in the “high risk” category should stay at home for 12 weeks.

Whitty described the advice to pregnant women as “a precautionary measure” because “we are early in our understanding of this virus and we want to be sure.”

Specific demographic data is limited, making it too early to say for certain whether the coronavirus poses a particular threat to pregnant women.

On Feb. 28, for example, the World Health Organisation (WHO) published an analysis of 147 pregnant women (64 of whom were confirmed to have coronavirus, 82 who were suspected and one who had no symptoms) and found that 8 per cent had a severe condition and 1 per cent were critically ill.

According to the WHO, most people (about 80 per cent) recover from the disease without needing special treatment but for one out of every six people who get COVID-19 becomes seriously ill and develops difficulty breathing.

Public Health England and the World Health Organisation continue to advise the best way to avoid contracting coronavirus is to wash your hands regularly and avoid contact with people who are unwell.

In addition, experts advise pregnant women during the current time to do this:

• If you have a routine scan or antenatal appointment booked, you still need to attend, but timings for appointments may change.
• If you have concerns about the pregnancy, still, contact your doctor.
• Please do not bring children to antenatal appointments, and attend alone if possible.

 

NIGERIAN TRIBUNE