Updates on effect of Covid-19 on pregnancy

Detailing here some of the latest information on the effect of COVID-19 on pregnant women and the baby.

Pregnant women with COVID-19 will more likely require intensive care than those without infection but the risk to the fetus is very low. There is a slight chance of preterm birth or cesarean delivery, but the risk of death of babies is very low. For sure COVID-19 has not been linked to an increase in stillbirth, miscarriage or any growth restriction.

The chances of any vertical transmission have not been determined anywhere. It has been noticed that the infants are not getting affected by the virus, based on samples taken from the placenta and umbilical cord. But few studies show that, based on the little data available that the virus may damage the placenta which can cause injury to the fetus.

This respiratory virus is more serious to pregnant women as their lungs are already working harder than usual and as the uterus keeps growing it puts more pressure on the diaphragm, thereby reducing the lung capacity. The oxygen supply is also now divided between the baby and mother. Overall the mother’s immunity is also reduced to not harm the baby. Multiple studies show that other risk factors like obesity, high blood pressure and gestational diabetes can worsen the COVID-19 during pregnancy. But more data is required to confirm all these facts. All these make pregnant women more susceptible to this virus.

The risk factors of COVID-19 on pregnant women increases for those who are,

  • over 35 years of age
  • obese
  • having immunosuppressive medication
  • having chronic diseases like HIV, diabetes, heart diseases, chronic liver disease, kidney or lung disease.

As in the case of vaccination, it is very unlikely of it to cause any side effects on the mother or baby. Studies are still going on monitoring the effects of it on pregnant women. But always ensure to discuss with your doctor before planning to take the vaccination when pregnant, because if you suffer from any chronic illness then you may have to avoid taking the vaccine.

Who all can take the vaccinations for COVID-19?

  • Pregnant women after 14 weeks, can take vaccination against COVID-19 according to new protocols and guidelines.
  • Those patients trying to conceive can also take the vaccine.
  • Breast-feeding mothers can take the vaccine as well.

 

Being pregnant may appear to worsen the clinical course of COVID-19 compared to a non-pregnant lady. Alpha and delta variants have a prelidiction for pregnant women. In severe cases, anti viral medication, steroids and mono clonal antibodies may be given to the patient.

Recommended therapies based on the severity of illness –

  • Asymptomatic – no treatment
  • Mild COVID, hospitalization no required – Bamlanivimab may be suggested by the doctor so it does not progress to a more severe situation.
  • Hospitalized but supplemental oxygen therapy not required – IV Remdisivir/Oral Favipiravir + Bioferon nebulization + VTE Prophylaxis may be suggested by the doctor
  • Hospitalized and requires supplemental low oxygen flow – IV Remdisivir/Oral Favipiravir + Bioferon nebulization + VTE Prophylaxis+ steroid injections may be suggested by the doctor

When do we need to admit to hospital?

  • Shortness of breath
  • Haemoptysis
  • Chest pain/heaviness not related to cough
  • Persistent fever>38 even after having medicines for more than 3 days
  • RR>20
  • Heart rate >110bpm
  • Oxygen saturation < 95%

To view previous blogs on pregnancy and Covid-19 please click on these links –

‘Novel Corona Virus(COVID-19) and its impact on Pregnancy’

‘Are you Pregnant? Worried about COVID-19: FAQs – Answered by Dr. Shiva Harikrishnan’

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