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A Note to Expecting Mothers from a Gynaecologist On How to Manage Pregnancy in Pandemic

Image: Getty Images

Image: Getty Images

It is important to for all pregnant women to get their facts right about COVID-19, its mode of transmission and risks associated to better protect themselves.

Shivani Sachdev Gour
  • Last Updated: June 13, 2020, 12:16 PM IST
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As the number of new novel coronavirus cases increase in India - pregnant women stress more about the effects it will have on their pregnancy.

UNICEF data shows that India will have the largest burden of Covid19 pandemic baby births in the world, with about 20 million babies in 2020 under the shadow of Covid19.

ICMR research shows that pregnant women do not appear more likely to contract the infection than the general population. However, pregnancy itself alters the body’s immune system and response to viral infections in general, which can occasionally be related to more severe symptoms and this will be the same for COVID-19.

Data also shows that reported cases of COVID-19 pneumonia in pregnancy are milder and with good recovery, but pregnant women with heart disease are at highest risk (congenital or acquired).

There have also been case reports of preterm birth in women with COVID-19 but it is unclear whether the preterm birth was due to Covid19, or whether some were spontaneous.

The coronavirus pandemic also increases the risk of perinatal anxiety and depression, as well as domestic violence. It is critically important that support for women and families is strengthened as far as possible.

Here's some ways pregnant women can prevent catching the deadly virus.

Stay at home as much as possible and keep the number of visitors at home including maids to a minimum. Keep social distancing of atleast 1 meter from any other person in the house. Wash hands frequently with soap and water for atleast 20 seconds or use a disinfectant. Cover mouth and nose with bent elbow or tissue during coughing or sneezing and dispose the tissue in the bin. Avoid touching eyes mouth nose as much as possible.

The question remains, is it unsafe for pregnant women to go out for something like grocery shopping, or back to office spaces?

Grocery shopping is not advisable especially as she may be exposed to many people in a small area without proper ventilation, and at present, work from home is advisable especially in the last 3 months of pregnancy and public transport is not reccomended.

The first trimester is usually the most stressful of all as it brings with it undesirable symptoms like nausea,vomiting,fatigue, weakness and giddiness,fear of pregnancy loss makes it very difficult for some women to cope. With appropriate medications,counselling and dietary changes women usually overcome these symptoms by the end of 12 weeks. As women reach their second trimester they are more relaxed and calm.

It is important to for all pregnant women to get their facts right about COVID-19, its mode of transmission and risks associated to better protect themselves and avoid believing rumours and fake news circulating in social media,which is likely to create unnecessary panic.

There is currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19. With regard to vertical transmission (transmission from mother to baby antenatally or intrapartum), 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. So far very few babies have tested positive once the mother had COVID later in pregnancy. Most babies were not infected.

There are no signs that COVID-19 increases the risks of birth defects, although there are only a few women in literature who got the virus at this stage and are yet to deliver their babies.

Pregnant women can keep visiting hospitals only when called with no/one attendant to ensure safety, keeping in touch with their obstetrician on phone regarding the scheduled visits.

They can continue with their routine Antenatal visits as per advise of obstetrician although they maybe fewer in number or more spaced according to clinical profile. Simple queries should be addressed on phone itself. Patient should also make arrangements and stock up essential medicines for few months in case there of closure of clinic or society.

Excessive stress during pregnancy is associated with preterm labour, preterm delivery, gestational hypertension, gestational diabetes and can also negatively effect growth of baby and can result in low birth weight babies. Every possible step should be taken to avoid stress.Watching favourite television show and book helps to avoid negative thoughts from mind.

Most pregnant women are currently stressed out about the thought of going into labour during these times - is it safe?

In anticipation of hospital admission, women are advised to discontinue work or begin working from home a minimum of 2 weeks prior to anticipated delivery, and to practice strict social isolation during this time, to limit the risk of exposure.

COVID testing in pregnant women is done as per ICMR guidelines which include all symptomatic patients and direct contacts of high risk patients and asymptomatic women residing in hotpot, cluster or containment area.

After the birthing process, women are advised rest, as compromised immunity will make one more susceptible to catching the virus.

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