COVID-19 And Pregnancy: What Are The Risks? Doctors Explain

New Delhi: Recently, a Mumbai based woman who was in her late 20s suffered a miscarriage due to COVID-19, stated a study done by National Institute of Research in Reproductive Health (NIRRH). This is the first time a miscarriage due to COVID-19 is being reported in India. The woman, a security guard in a government hospital in Mumbai, was in her first trimester and had contracted COVID-19 when she was eight weeks pregnant. Earlier, the woman showed no symptoms, but a precautionary nasopharyngeal test returned positive for the virus, and she was admitted to institutional isolation. About four weeks later, a second test showed no trace of the virus, but a week later (when she was 13 weeks pregnant), a routine ultrasound test found that the foetus had died.

Th doctors in this particular case concluded that SARS-CoV-2 virus had travelled into the umbilical cord, placenta and possibly caused inflammation and the death in the foetus. The paper was posted on August 22 on MedRxiv, an online site that publishes pre-prints of medical and scientific papers.

There are not many known COVID-19 related complications in pregnancy that has been documented and there is also the limited research on how the novel coronavirus can affect the unborn child. To know about the case in details and COVID-19 impact on pregnancy, NDTV speaks with top doctors.

Also Read: Mothers Should Continue To Breastfeed Even If They Are COVID-19 Positive, Experts Say It Is ‘Safe’

Talking about the risks involved in pregnancy during COVID-19 times, Dr Kaberi Banerjee, Gynecologist says,

The vertical transmission in COVID has been reported to be lower than other viruses. Like in SARS virus the vertical transmission rate from the mother to the baby is about 25 per cent but in COVID, as we all know, is a new virus and is evolving virus, the studies about the transmission and the total number of such cases is still limited to the medical community. But we can give a rate about less than 5 per cent. However, we all know that this virus is always evolving and maybe we will see some more cases of vertical transmission as we have seen in the Mumbai case.

Dr Banerjee further adds that the literature so far has said that there is a risk of placental contamination with this virus as we have seen in Mumbai case but it is very-very less. She said,

However, very less doesn’t mean zero risk. In every decision in life, we need to do the risk and benefit analysis, I think, if the women go ahead and take all the precautions like wearing mask, social distancing and hand hygiene, I think they will be good to go ahead with their pregnancies.

Giving advice to all the mothers to be and how they can save themselves from the possible COVID virus, Dr Banerjee said,

We have seen that the incident of total number of cases to the total number of recoveries is very very high and as many people are saying we cannot put lives on hold as we don’t know when this virus will go, we don’t know when the vaccine will come. So the advice is that we can still go ahead with conception having known that the risk of preterm labour (delivery before time) is slightly higher in pregnancies with COVID, the risk of transmission from mother to child is low, even in fertility and natural pregnancy, people are going ahead with their lives, it is just that they need to know about the possible risk factors. But at the same time the risk is not that huge to hold on pregnancies till the indefinite time.

Also Read: Pregnancy In The Times Of A Pandemic: What Impact Can COVID-19 Have On Moms-To-Be And Babies

Dr. Jyoti Vajpayee, a gynecologist based in Lucknow highlighting the fear and uncertainties in pregnant women due to COVID said,

Pregnant women are vulnerable to the COVID-19 infection because of the changes in their body and the immune system so it has been advised by the government that pregnant women should take extra precautions just as the elderly. This creates a sense of fear and anxiety in women who are pregnant. They are missing their ante-natal check-ups which may cause further complications later on. We still need a system in place for online check-ups so that the contraction risk is reduced to zero and the vulnerable group like the pregnant women doesn’t have to step out of the house.

Also Read: Expert Blog: Why Is The Focus On First 1000 Days From Health Perspective Of Mother And Child?

Dr. Rakesh Sahay, Endocrinologist and Diabetologist, and Professor at Osmania Medical College in Hyderabad adds that still limited information is out there when it comes to COVID-19 and its impact on pregnant women but we have seen cases previously where COVID-19 mothers have given birth to healthy and normal children WHO were also not infected with the virus and now the first case has come up which has linked COVID-19 with miscarriage, so there is still a lot which needS to be researched and covered in terms of COVID and its impact on pregnant woman.

Currently, in order to guide pregnant women in managing their pregnancy and healthcare workers in taking care of pregnant women, Indian Council for Medical Research (ICMR) and National Institute for Research in Reproductive Health (NIRRH) have issued a set of guidelines. As per the guidelines, if a woman meets the criteria for COVID-19 testing, she should be tested and until test results are available, she should be treated as though she has confirmed COVID-19. The guidelines also say that pregnant women with heart disease are at the highest risk of becoming COVID-19 positive and all the pregnant women are advised to increase their social distancing to reduce the risk of infection and practice hand hygiene at all the times.

The guided documents also says that during the term of pregnancy and delivery process, a single person should be permitted to stay with the women and if pregnant women are self-quarantined because someone in their household may have symptoms of COVID-19, doctor’s appointments should be delayed for 14 days.

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.