SARS-CoV-2/COVID-19 - Pregnancy & Birth

Expert findings on the impact of Covid on pregnancy & birth

Information on SARS-CoV-2/COVID-19 during pregnancy, birth and the first 6 weeks after.

The following content is taken from previously published recommendations of the German obstetric societies of gynecologists and pediatricians.(DGPM, DGGG, DGPGM, DGPI, GNPI, NSK) October 2020
However, the state of knowledge can change at any time due to new results. The final decisions are always made by your specific treating specialists.
We do not guarantee completeness.

What we can say in general:

  • There is currently no evidence for a generally higher risk of infection with SARS-CoV-2 during pregnancy. Pregnant women are recommended the general measures for infection avoidance.

Import information for pregnant women who are Corona negative:

  • OB Gyn/clinic: Pregnant women must wear a medical mouth guard. You should go to the appointments alone, with exceptions depending on your personal situation.
  • Birth: Wearing a medical mouthguard is required when you arrive at the clinic. Wearing a mouthguard is not mandatory in the delivery room during birth. The accompanying person must wear a medical mouthguard during birth. The presence of a healthy accompanying person during birth is possible and is considered reasonable by professional societies. Corona tests are performed in the clinic before admission in almost all hospitals. In fact, of all infected (positive) pregnant women, up to 89% are asymptomatic.
  • Pain relief: N2O (laughing gas): this method is currently not recommended in Germany because aerosols are produced.
    PDA/SpA: these methods are possible without restrictions.
  • Vaccination (SARS COV-2): Vaccination for pregnant and breastfeeding women is currently not recommended due to data availability.
     

Important information for pregnant women who are Corona positive:

  • Examinations: A close monitoring with sonographic follow-up at 2- to 4-week intervals is recommended. If the infection occurred in the first trimester of pregnancy, a first trimester screening or an extended fine diagnosis by ultrasound should be considered. This is recommended by the professional societies.
  • Miscarriages: Miscarriages did not occur more frequently during the SARS-CoV-2 pandemic, but the data are still insufficient for a conclusive assessment.
  • In utero transmission: A possible transmission has been reported in several cases, suggesting that infection in the womb is possible but rare (< 3% of maternal infections). Most neonatal infections are thought to be due to aerosols after birth.
  • Medications: Medications typical of pregnancy can be continued without concern. There has been no evidence of a change in effect.
  • ASS (aspirin): In case of a corona infection during pregnancy, the gynecologist should check with the pregnant woman whether prophylactic aspirin should be taken. This may be recommended in some circumstances.
  • Thrombosis prophylaxis: The risk of thrombosis in the case of a corona infection should be reduced by regular exercises, sufficient fluid intake and, if necessary, compression stockings and, if necessary, taking aspirin. A consultation with the attending OB Gyn is absolutely necessary. By the way, this also applies to the postpartum period (6 weeks after delivery).
  • Delivery: The woman giving birth should deliver with a medical mask if possible. However, the exception to this is if the mother's oxygen saturation is too low or her general condition deteriorates.
    The baby is constantly monitored by CTG and the mother's oxygen saturation is measured. It is also important to keep the mother hydrated.
    IMPORTANT: A corona infection is not an indication for immediate delivery! Only the condition of the mother or the child can make a delivery necessary. Even induction without additional reason is not necessary.
    Vaginal delivery is clearly recommended in Germany. The high cesarean section rates at the beginning of the pandemic resulted from unclear disease progression and data. 
    Unfortunately, water birth is not possible.
  • PDA/SpA: A corona infection is not a contraindication. In case of a possible cesarean, regional anesthesia should be used if possible. General anesthesia poses a higher risk to the staff.
  • N2O (laughing gas): This method is not recommended because aerosols are produced.
  • Postpartum: Separation of a positive mother and her baby is not mandatory if hygiene rules and measures to prevent viral transmission are followed. Skin-to-skin contact between mother and child should be allowed while adhering to hygiene rules and measures (hand disinfection, mouth guards, no mucosal contact, no kissing…). The newborn's risk of being infected with Corona by the mother is low. Separation from the mother is not required for positive tested newborns. The newborns are rarely symptomatic.
  • Breastfeeding is possible despite Corona infection (if hygiene rules are followed). The risk of transmission of SARS-CoV-2 through breast milk remains unclear but unlikely. In addition to the known benefits of breastfeeding, it is also conceivable that breastfeeding may provide passive immune protection.

If you have any questions, you can either contact us or your OB Gyn.

 

January 2021 Gravidamiga
This blog post is a personal recommendation and based on personal experience. It has been prepared with the greatest possible care and does not claim to be correct, complete or up-to-date.“

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