Questions about pregnancy and COVID-19: doctor's answers

Column by Oleksandr Popkov, Obstetrician-Gynecologist, Head of the Obstetric-Gynecological Department of the Medical Network "Dobrobut"

Questions About Pregnancy and COVID-19: Doctor's Answers

Pregnancy is a particularly important time in a woman's life when she is responsible for both her health and her baby's health. In a time when the world is facing the COVID-19 pandemic, patients have many questions related to pregnancy and COVID-19: safety measures, behavior, and possible complications.

I have compiled the most common questions and answers so that expectant mothers can protect themselves and their babies and safely navigate through the epidemic.

Should pregnant women go outside now?

You can go outside if you can ensure minimal contact with other people. The virus spreads through droplets in the air, so the optimal distance to maintain between people is 1.5-2 meters. Even if a person is not coughing and appears healthy, I recommend maintaining this distance for your safety. Many people are currently going out of the city or to parks to protect themselves from the virus. However, it is important to remember that the main thing is not where you are, but your ability to maintain this distance from others. Additionally, when touching any surfaces outside your home, it is essential to carry a disinfectant and use it. And, of course, upon returning home, you must thoroughly wash your hands—this is the most effective method of protection.

Should I go to the doctor immediately during quarantine if I just found out I’m pregnant?

If pregnancy has already been confirmed, for example, by a test, and you do not have an urgent need to see a doctor—if you had a successful previous pregnancy, and you are not experiencing severe pain or bleeding—I advise postponing the specialized visit to the doctor. Visiting a hospital right now may pose additional risks for you and your child. However, at 11-13 weeks of gestation, you should still plan a mandatory visit to the gynecologist, as this is the time when genetic ultrasound screening is performed.

What screenings and tests must be done even during quarantine?

This depends on the condition of the pregnant woman. If the woman is healthy and feels well, it is recommended not to skip mandatory ultrasound screenings that are tied to pregnancy timelines. On average, these occur at 11-13 weeks and 20-22 weeks of pregnancy. During this time, it is essential to plan a visit to the doctor, where blood tests will be taken. A urine test can also be important—this depends on the initial condition of the pregnant woman. At a minimum, the first visit to the doctor should include comprehensive screenings and tests. From there, you will work with your doctor to develop a plan that meets your needs and minimizes possible risks.

How is COVID-19 treated in pregnant women? Is there a way to treat it without harming the child?

If we are talking about mild cases of COVID-19, treatment can occur at home, similar to the treatment of ARVI: rest, adequate fluid intake, and constant monitoring of your condition and body temperature. If the body temperature exceeds 38°, antipyretic medications within safe dosages for pregnant women can be used. However, it is advisable to consult a doctor before taking any medications. If more serious symptoms arise, such as difficulty breathing and coughing, it is essential to contact a doctor to determine the next steps for treatment. If hospitalization is necessary, there are designated maternity hospitals where pregnant women with COVID-19 are treated.

Currently, there is no specialized approach to treating pregnant women with the coronavirus disease. Treatment is symptomatic, taking into account the peculiarities of pregnancy. If the disease has severe manifestations, intensive therapy may be required.

If a pregnant woman with COVID-19 does not recover before childbirth, what are the risks that the virus may be transmitted to the child?

As of today, there is no evidence of vertical transmission of the virus from mother to child. Only contact transmission cases have been recorded. To prevent infection of the child, mothers with COVID-19 must use personal protective equipment during contact with the child and breastfeeding: wear masks, gloves, and disinfect hands and surfaces. This way, the infection cannot be transmitted to the newborn. On average, COVID-19 patients stop spreading the virus between days 14 and 20 of the illness, so it is necessary to monitor the course of the disease regularly while adhering to all safety measures during contact with the child.

What should pregnant women do if someone at home is sick with COVID-19, and there is no possibility to move to another residence?

This is a very serious question, as the virus enters the air and remains on surfaces for a certain period. However, if moving is not possible, special safety measures should be taken when living in the same apartment with a person sick with COVID-19:

• Allocate a separate room for the sick person, which should not be adjacent to other rooms in the apartment or house if possible.
• Prepare separate sets of bedding, towels, and dishes for use by the sick person.
• Minimize the patient's movement out of this room as much as possible.
• Regularly ventilate and disinfect the entire premises.
• Pay special attention to personal hygiene and personal protective equipment for everyone in this space.
• Minimize contact between the pregnant woman and the sick person who may spread COVID-19.

Hospitals have banned partner deliveries due to COVID-19. Is this necessary, and do hospitals have the right to do this?

Yes, hospitals have the right to do this. The fact is that medical facilities are currently operating under crisis conditions that they may not have even suspected a few months ago. The peculiar feature of the coronavirus disease is that an infected person can remain asymptomatic for a long time or have a mild asymptomatic course. Therefore, the presence of another person during childbirth poses a risk to the child. Such restrictions from hospitals providing obstetric support are absolutely justified during the pandemic.

During this challenging time, I wish expectant mothers to stay safe with their loved ones and remain calm. Attention to your well-being and adherence to all personal safety measures will protect your health and the health of your baby.

This material was prepared and published for the resource 4mama.