Management and Prevention of COVID-19 in Pregnancy and Pandemic Obstetric Care: A Review of Current Practices
Open Access
- 15 April 2021
- journal article
- review article
- Published by MDPI AG in Healthcare
- Vol. 9 (4), 467
- https://doi.org/10.3390/healthcare9040467
Abstract
Constant accumulation of data results in continuous updates of guidelines and recommendations on the proper management of pregnant women with COVID-19. This study aims to summarize the up-to-date information about the prevention and management of suspected/confirmed SARS-CoV-2 infection in obstetric patients and obstetric care during prenatal, intrapartum, and postpartum periods. We conducted a comprehensive literature search in PubMed for relevant English-written full-text reviews. We also included relevant guidelines and recommendations. In women with a low risk for infection and uncomplicated pregnancy, elective and non-urgent appointments should be postponed or completed through telehealth. Vaccination should be discussed and distance and personal hygiene preventive measures should be recommended. Routine ultrasound examinations should be adjusted in order to minimize exposure to the virus. Standardized criteria should evaluate the need for admission. Women with moderate/high-risk for infection should be isolated and tested with RT-PCR. The mode and timing of delivery should follow routine obstetric indications. In case of infection, glucocorticoids are recommended in critically ill pregnant women, after individualized evaluation. During labor and concomitant infection, the duration of the first two stages should be reduced as possible to decrease aerosolization, while minimization of hemorrhage is essential during the third stage. Close maternal monitoring and adequate oxygenation when necessary always remain a prerequisite. Discharge should be considered on the first or second day postpartum, also depending on delivery mode. Breastfeeding with protective equipment is recommended, as its benefits outweigh the risks of neonatal infection. Recommendations are currently based on limited available data. More original studies on infected pregnant women are needed to establish totally evidence-based protocols of care for these patients.Keywords
This publication has 59 references indexed in Scilit:
- Obstetric Anesthesia During the COVID-19 PandemicAnesthesia & Analgesia, 2020
- Maternal health care management during the outbreak of coronavirus disease 2019Journal of Medical Virology, 2020
- Labor and delivery guidance for COVID-19American Journal of Obstetrics & Gynecology MFM, 2020
- Coronavirus disease 2019 (COVID-19) pandemic and pregnancyAmerican Journal of Obstetrics and Gynecology, 2020
- Coronavirus in pregnancy and delivery: rapid reviewUltrasound in Obstetrics & Gynecology, 2020
- ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionalsUltrasound in Obstetrics & Gynecology, 2020
- Novel corona virus disease (COVID‐19) in pregnancy: What clinical recommendations to follow?Acta Obstetricia et Gynecologica Scandinavica, 2020
- Withdrawn: Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancyJournal of Infection, 2020
- Hospital Emergency Management Plan During the COVID‐19 EpidemicAcademic Emergency Medicine, 2020
- Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitroCell Research, 2020