Yesterday, the @RCObsGyn released Version 1 of their guideline for Coronavirus (COVID-19) infection in pregnancy.
Obviously data is limited & the situation is evolving, w/ further updates to follow. But below is a summary of current guidelines, with further info on their website
Obviously data is limited & the situation is evolving, w/ further updates to follow. But below is a summary of current guidelines, with further info on their website
As of current, pregnant women do not appear to be more susceptible to the infection than the general population
There is one case of possible vertical transmission, but otherwise it is though that vertical transmission does NOT take place
Symptoms are alike those in the general public. Mostly mild/mod flu like symptoms, and rarely pneumonia or marked hypoxia.
Currently no evidence to suggest increased risk of miscarriage/early pregnancy loss. As no evidence of vertical transmission, no evidence of congenital effects. One case report of PTL - unsure or secondary to infection or iatrogenic
Travel advice should be as per current foreign affairs guidelines and current travel advice in pregnancy.
As per advice to general pop. If concerned RE exposure/symptoms, designated helpline should be rang. (1850241850 in ireland). They should NOT attend GP/ED. 999 should be rang in emergency. Maternity healthy care provider should be informed via phone.
Self-isolation advice same as general population, with self isolation recommended for 14d. ROUTINE antenatal visits should be postponed until after 14d. If urgent care needed, maternity unit to be contacted in advance
If confirmed infection: unit informed, PPE applied at entrance of hospital and put in isolation room, with negative pressure it available. Only essential staff/items in room. This should be followed for both urgent and emergency care.
Labour and confirmed infection: to remain at home during latent phase if possible. If home birth was planned, hospital birth is recommended.
Continuous electronic fetal monitoring is recommended throughout labour.
MDT approach including: MFM, ID, neonataology, senior midwife, anaesthetics. However staff members entering room should be limited.
No recorded cases of COVID19 in vaginal secretions —> vaginal delivery not CI.
Spinal/epidural anaesthesia not CI.
Spinal/epidural anaesthesia not CI.
Adequate filter system must be used with Entonox.
Second stage of labour should be shortened if woman becomes hypoxia.
DCC still recommended.
DCC still recommended.
Elective LSCS should be at end of list. In second theatre if possible. Minimal staff in theatre, with PPE.
Assessment should be made of safe to delay elective procedures in confirmed cases of infection
Assessment should be made of safe to delay elective procedures in confirmed cases of infection
Assessment should be made of elective IOL can be delayed in confirmed cases of infection.
As with PET, maternal stabilisation should occur as priority before delivery.
All babies born to mothers with infection should be tested for COVID19
Precautionary separation of an infected mother and well baby is not recommended
Precautionary separation of an infected mother and well baby is not recommended
So far, breast milk has tested negative to COVID19. The risk of infection is secondary to the close contacted associated with BF. This should be discussed, but BF is not CI
The following advice should be offered: meticulous hand washing, wearing a face mask while BF, clean pump after each use, ask someone to feed baby with EBM.
Strict sterilisation should be used if bottle feeding
Strict sterilisation should be used if bottle feeding
