Pregnancy and Coronavirus

In the last days of 2019, the event, which started as a ‘strange disease’ that could not be fully detected at first in the Wuhan region of China, was soon found to be an infection triggered by a new type of virus belonging to the Coronavirus family. This new type of virus, which is thought to have passed from a place selling seafood to humans for the first time, has spread almost all over the world with an unpredictable speed in a very short time, especially in China.

This new type of virus that causes severe acute respiratory syndrome (SARS and MERS) from the common cold in humans 11.02. In 2020, it was named Covid-19 as an abbreviation of Coronavirus 2019 by the World Health Organization. Then, on 11.03.2020, again by the World Health Organization, Covid-19 disease, in its simplest terms, declared a pandemic, which is the situation given to diseases that threaten a large number of people simultaneously in the world. According to Worldometers, a reliable reference website that provides real-time statistics, there are 1,727,602 cases and 105,722 deaths all over the world today (April 11.

The lack of an immediate understanding of what causes the disease and how it spreads has resulted in inadequate isolation. Since it takes time to realize that the disease is a serious condition that can cause death rather than a simple flu, the figures continue to rise rapidly in the graphics. The whole world was caught unprepared for the pandemic, causing panic and chaos in a short time, due to the lack of a proven vaccine yet, the lack of sufficient number of healthcare teams, hospitals, beds, intensive care and respiratory support devices to carry out the treatment.

The uncertainty of this chaotic situation naturally causes stress and anxiety in expectant mothers. However, information pollution in social media increases anxiety even more.

Despite being caught unprepared, the rapid sharing of experiences, data and new information all over the world also enables rapid progress in the prevention and treatment of the disease.

1. We do not have enough information about whether Covid -19 causes poor pregnancy outcomes such as miscarriage, stillbirth, congenital anomalies. Although the data are scarce, there is no evidence that Covid-19 is transmitted to the baby in the womb. Although Covid-19 has not been detected in the placenta, amniotic fluid and breast milk so far, there are few cases of Covid-19 detected in the neonatal period, possibly due to postpartum person-to-person contact.

2. Although it is not yet clear whether Covid-19 causes more serious illness in pregnant women, the current data show that the rate of serious progression of the disease is not higher in pregnant women than in the normal population. However, pregnant women should pay more attention to protection and isolation due to the changes in their bodies and immune systems.

3. Pregnant women with complaints such as fever, cough, and shortness of breath should definitely apply to a health center. High fever, especially in the first 3 months, can have a negative effect on the fetus. In these centers, priority should be given to pregnant women for testing. If deemed necessary, chest CT (computed tomography) can be taken with abdominal protection.

3. For pregnant women who are diagnosed or suspected of Covid-19, the mode of delivery should be planned in line with medical requirements in the same way as for pregnant women who are not sick. Being positive for Covid 19 does not require a cesarean section. Due to the anxiety caused by the spread of the pandemic, it is a wrong approach to give birth to healthy pregnant women before their expiration date.

4. A pregnant woman diagnosed with or suspected of Covid-19 should notify the place where she will give birth, if possible, when labor symptoms begin. This provides time for the delivery team to prepare the necessary protective equipment and a special room. Anesthesiologist should definitely evaluate the pregnant woman who started labor. It allows to be prepared in advance for a possible emergency cesarean section. In cases where cesarean section is required, epidural/spinal anesthesia should be preferred instead of general anesthesia. In order to minimize the spread in non-sick pregnant women, only one companion should be present when they are hospitalized for delivery and this person should not change. The pregnant woman and the companion must wear a surgical mask.

5. A limited number of publications have reported that Covid-19 has not been detected in breast milk, but more data are needed to clearly state that there is no transmission through breast milk. In a mother who is positive for Covid-19, the decision to breastfeed is left to her. If the general condition of the mother is suitable, after the hands are washed and disinfected properly, she can breastfeed by wearing a mask. If the general condition of the mother is not suitable and it is still desired to be breastfed, milk can be expressed and given to the newborn baby with a pump that has been washed and disinfected under appropriate conditions. At this stage, it is recommended that the person who will give milk to the baby or the healthcare professional not be someone who takes care of the mother.

Our knowledge of pregnancy and lactation until today is limited to this much. It will be clarified in the coming days whether Covid-19 has long-term effects.

It is hoped that the pandemic will come to an end by informing the whole society correctly, preventing the spread of misinformation on social media, and understanding the importance of isolation and social distance for every individual.

Scientific studies on Covid-19 will continue after the acute period is over, however, each of us as individuals must evaluate and understand very well the message Covid-19 gives to the world and humanity.

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