18 March 2020

COVID-19 advice for the worried pregnant patient

Communicable Disease O&G Women

Pregnant women may be reassured that, given current evidence from the COVID-19 outbreak, they seem to be suffering mild and moderate infection only, the Royal Australian and New Zealand College of Obstetricians Gynaecologists (RANZCOG) has said.

Updated guidelines published this week by RANZCOG say pregnant women in China who contracted an infection of SARS-CoV-2 were not observed to be any more unwell than the general patient population.

RANZCOG also noted this advice was significantly different from that for seasonal influenza, which we know can cause harm to both pregnant women and their babies.

“Following the declaration of the COVID-19 (coronavirus) pandemic, we understand that all pregnant women will feel a great sense of anxiety about their own health and that of their unborn or newborn baby,” RANZCOG said.

“Most of the information regarding the impact of COVID-19 infection on pregnant women and their babies remains limited by the recency of the disease emergence. Therefore, our pregnancy advice is based on learnings from influenza infection, and also the medical response to the SARS epidemic in 2003,” RANZCOG said.

It is expected a majority of pregnant women who have COVID-19 will only experience mild or moderate cold and flu like symptoms.

In addition, there was no evidence to suggest women trying to conceive or in early pregnancy had an increased risk of miscarriage with COVID-19.

There was also no evidence to suggest that vertical transmission between the mother and foetus was occurring, nor in abnormalities after birth.

But RANZCOG conceded that some babies born to women with symptoms of coronavirus in China had been born prematurely.

“It is unclear whether coronavirus was the causative factor, or the doctors made the decision for the baby to be born early because the woman was unwell,” RANZCOG said.

Pregnant women should be advised to follow all up-to-date public health advice including hand washing, social distancing and seeking medical attention if symptoms appear.

Pregnant women are also advised to avoid all non-essential travel and remember to receive an influenza vaccine to prevent other infection.

RANZCOG fellows are also advised to start thinking about how to best protect pregnant women in both the clinic and hospital settings, such as:

  • Reducing, postponing and/or increasing the interval between antenatal visits
  • Shortening the duration of antenatal visits
  • Using telehealth consultations as a replacement, or in addition, to routine visits
  • Avoiding face to face antenatal classes
  • Limiting visitors (partner only) while in hospital
  • Considering earlier discharge from hospital than would otherwise be planned
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