Covid-19's effect on pregnant women

Novel coronavirus (SARS-COV-2), which the World Health Organisation (WHO) has announced to be a pandemic, is a new strain of coronavirus causing COVID-19, first identified in Wuhan City, China. It has affected more than 183 countries, killing more than 200,000 people, with the worse affected countries being USA, Italy and Spain.

Most cases of COVID-19 globally have evidence of human to human transmission. There are two routes by which COVID-19 can spread. The first is directly through close contact with an infected person (within two metres) where respiratory secretions can enter the eyes, mouth, nose or airways.

The second route is indirectly via the touching of a surface, object or the hand of an infected person contaminated with respiratory secretions and subsequently touching one’s own mouth, nose or eyes.

While the general population is susceptible to COVID-19 infection to varying degree depending on preexisting risk factors, it is important to know its implication in women who are pregnant, planning fertility and not pregnant women in general.

SARS-COV-2 is a new coronavirus and therefore the evidence currently available to guide clinical management in this situation is sparse.

Coronavirus and pregnancy

Pregnant women do not appear to be more likely to contract the infection than the general population. Pregnancy itself alters the body’s immune system and response to viral infections in general, which can occasionally cause more severe symptoms. The absolute risks are, however, small. This will be the same for COVID-19.

If you develop symptoms like fever, cough, sore throat, chest infection, contact your maternity unit immediately

According to Royal College of Obstetrician and Gynaecology, there are currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to CO- VID-19. There is also no evidence currently that the virus is teratogenic. With regard to vertical transmission (transmission from woman to her baby during pregnancy or delivery), emerging evidence now suggests that vertical transmission is probable, although the proportion of pregnancies affected and the significance to the neonate has yet to be determined.

Due to rapidly changing situation of COVID-19 infection globally, important health and safety decisions are made by officials to restrict spread of illness. This is because if the number of infections were to rise, the number of severely infected pregnant women could also rise.

Precautions and safety measures for pregnant women

Currently we have limited information available about how COV- ID-19 could affect pregnancy, but it would be crucial for pregnant women to strictly apply social distancing measures to reduce the risk of infection. Department of Health has protocols and guidelines for each state for COVID-19. Please follow the health instructions as advised by Queensland Health.

If you develop symptoms like fever, cough, sore throat, chest infection you are recommended to contact your maternity unit, fever clinics or 000 Emergency straight away for further information and advice.

Pregnant women are encouraged to self-mobilise at home and keep themselves well-hydrated, which will reduce risk of developing deep vein clots.

Many hospitals and GP centres are doing Telehealth to avoid close contacts; however, it is recommended to attend your routine antenatal appointments if asked to do so. Maternity care is essential and has been developed over many years to reduce complications in pregnant women and babies, therefore it is important that you keep in contact with your maternity team or GP and continue to attend your scheduled visit via telehealth or in person.

If you any concerns including the baby’s movements, pain, vaginal bleeding, rupture membranes, you must seek advice and care from maternity services without delay. If you have an urgent problem related to your pregnancy get in touch using the same emergency contact details you already have.

This pandemic has resulted in an increased amount of anxiety in the general population, and even more so for pregnant women. These anxieties are likely due to COVID-19 itself, the impact of social isolation and major changes in antenatal care, including appointments being changed from face-to-face to telephone contact.

While pregnant women’s health may get affected, non-pregnant women’s general health is also a concern.

Besides using health precautions to prevent themselves from COVID-19 virus infection, they also need to safeguard their general health. Women who have other gynaecological issues like heavy periods, post-menopausal bleeding, pelvic pain, painful periods, pelvic mass and other medical condition requiring urgent medical attention should seek medical advice in timely manner. Women should discuss these issues with their respective GP who can give them appropriate advice, treatment and specialist referral if appropriate.

Pregnant women do not appear to be more likely to contract the coronavirus than the general population

Every Individual should practice social distancing and health safety measures to keep themselves and their community safe. It is very important that we all work as a team to overcome this deadly pandemic.

While every measures are taken by department of health to prevent spread of coronavirus infection, it is our civic responsibility that we should keep ourselves updated with new guidelines and follow them strictly. With good social distancing, hygiene and multiple preventative measures being taken, we can help defeat coronavirus globally.

By Dr Vidhya Gupta M.B.B.S, FRANZCOG

Obstetrician, Gynaecologist and Fertility Specialist

Vice President, Indian Medical Association of Australia (Queensland Chapter)