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

While information regarding COVID-19 and pregnancy is limited, doctors say that due to the changing immune system during pregnancy, women need to take extra precautions to avoid infections

Can coronavirus be transmitted from a COVID-19 positive mother to the fetus? Here is what experts have to say
Highlights
  • Being in a delicate condition, pregnant women must take precautions
  • There is no evidence that virus can be transmitted from mother to the fetus
  • There is currently no data suggesting risk of miscarriage due to COVID-19

New Delhi: Pregnancy can be stressful even under normal circumstances but during a pandemic, the anxiety can increase exponentially. In an open webinar on pregnancies conducted by doctors of the All India Institute of Medical Sciences (AIIMS), New Delhi, a senior gynaecologist-obstetrician said that they are preparing for the possibility that the number of pregnant women infected with Covid-19 would increase. Since pregnancy comes with significant changes in the body including the immune system, it is important to take extra precautions to avoid catching the infection. There are also concerns on how risky the pregnancy would be and if the mother can transmit the infection to the baby in the womb. However, experts say that there is no need to panic because as of now there only have been cases of COVID-19 positive pregnant women delivering babies who have tested negative. For example, recently a COVID-19 positive woman in Aurangabad Civil Hospital gave birth to a baby who did not get the coronavirus from its mother but is being kept in a separate ward to avoid the risk of catching the virus through aerosols.

Also Read: Breastfeeding And Coronavirus Outbreak: Here Is What Nursing Mothers Should Know

Here is what medical experts have to tell many mothers-to-be who are worried about looking after themselves and their babies during the Covid-19 pandemic.

Talking about the challenges of being pregnant during COVID-19 outbreak, Dr. Shweta Khandelwal, an expert at Public Health Foundation of India (PHFI), a not for profit public-private initiative working towards strengthening health in India said that only a small number of studies reporting a limited number of cases are available for reference till now. She said,

Pregnancy itself is a vulnerable stage as we nurture another life within us thus in a state of partial immune suppression which makes pregnant women more vulnerable to viral infections, and the morbidity is higher even with seasonal influenza. So yes, pregnant women must be very careful during this time when COVID-19 is causing this entire catastrophe globally. That said, there is no need to panic. Most experts agree that pregnant women do not appear more likely to contract the infection than the general population.

She further said that most of the women who have been studied under some case reports had COVID-19 during the third trimester of pregnancy. As of now, there is no evidence of any fetal malformations or effects due to maternal infection with COVID-19 at least in India, according to Dr. Khandelwal.

She recommended that expecting mothers should maintain hygiene, avoid unnecessary contact with people or surfaces, meditate, stay calm, eat healthy, be hydrated and rest well.

Also Read: One Death Occurs Every 11 Seconds Among Babies And Pregnant Mothers, Says United Nations

On precautions that pregnant women need to take, Dr. Neerja Bhatla, a professor of gynaecology and obstetrics at the AIIMS said during the webinar,

It is important that pregnant women abide by social-distancing measures and as much as possible communicate with doctors through teleconsultations. Their family members should also take special care to practise social distancing.

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. According to the guidelines, it is critical that family support for women is strengthened as far as possible and their mental health and well-being is looked after. It specifies that 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.

Via the guidance document, ICMR and NIRRH further say that pregnant women with heart disease are at the highest risk of becoming COVID-19 positive. Pregnant women are advised to increase their social distancing to reduce the risk of infection and practice hand hygiene, as per the guidelines. It also says that during the term of pregnancy and delivery process, a single person should be permitted to stay with the women. Visitors should be instructed to wear appropriate personal protection gears, including gown, gloves, face mask, and eye protection.

If required, the number of visits to the hospital during pregnancy may be reduced in consultation with the doctor. It further says that if there is a need to visit a health centre, then the women should be driven in a private vehicle or in an ambulance by calling 108 services.

For women who are self-quarantined because someone in their household may have symptoms of COVID-19, doctor’s appointments should be delayed for 14 days.

On the effect of COVID-19 on the pregnancy, ICMR says that there is currently no data suggesting an increased risk of miscarriage or early pregnancy loss and the novel virus is currently not leading to Medical Transmission of Pregnancy.

Also Read: Over 50 Per Cent Of Pregnant Women In India Are Anaemic, Reveals National Family Health Survey

Can A COVID-19 Positive Pregnant Woman Pass On The Infection To Her Baby In The Womb?

Health agencies around the world like the World Health Organisation (WHO), Centre for Disease Control (CDC), USA and ICMR say that as of now it is not known if a pregnant woman with COVID-19 can pass the virus to her fetus or baby during pregnancy or delivery and the virus has not been found in samples of amniotic fluid which is found in the innermost membrane that encloses the embryo.

According to Dr. Rakesh Sahay, Endocrinologist and Diabetologist, and Professor at Osmania Medical College in Hyderabad, limited information suggests that COVID-19 does not cross the placenta and get to the fetus. Thus the baby is safe inside the womb but after delivery, if the mother has been tested positive or is suspected of having COVID-19, she should be temporarily kept in a separate room until no longer suspicious and should touch baby while taking precautions like wearing a mask, cleaning hands properly. This is because aerosol/ respiratory droplets generated from a COVID-19 positive mother can transmit to the infection to the baby. He said,

There are a few cases of pregnant women catching the infection, and in all these cases we have seen that children who were born were not infected. So till now, we have seen that there is no transmission from mother to child inside the womb. But there is a need to precaution once the child is out of the womb to avoid any infections.

Dr. Khandelwal also, seconds Dr. Sahay and said that pregnancy does alter the body’s immune system but with regard to transmission from mom to baby, previous case reports from China suggested that there was no evidence for this and amniotic fluid, cord blood, neonatal throat swabs, placenta swabs, genital fluid and breastmilk samples from COVID-19 infected mothers have so far all tested negative for the virus. However, she further said that more research is warranted to determine the proportion of pregnancies affected and the impact on the neonate.

Also Read: New Study Highlights That Pregnant Women Often Lack Adequate Nutrition

World

24,06,78,961Cases
20,23,40,977Active
3,34,39,331Recovered
48,98,653Deaths
Coronavirus has spread to 195 countries. The total confirmed cases worldwide are 24,06,78,961 and 48,98,653 have died; 20,23,40,977 are active cases and 3,34,39,331 have recovered as on October 18, 2021 at 4:17 am.

India

3,40,81,315 13,596Cases
1,89,6946,152Active
3,34,39,331 19,582Recovered
4,52,290 166Deaths
In India, there are 3,40,81,315 confirmed cases including 4,52,290 deaths. The number of active cases is 1,89,694 and 3,34,39,331 have recovered as on October 18, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

65,91,697 1,715

32,230 994

64,19,678 2,680

1,39,789 29

Kerala

48,54,321 7,555

88,186 3,292

47,39,270 10,773

26,865 74

Karnataka

29,83,459 326

9,479 58

29,36,039 380

37,941 4

Tamil Nadu

26,87,092 1,218

14,814 208

26,36,379 1,411

35,899 15

Andhra Pradesh

20,60,472 432

6,034 159

20,40,131 586

14,307 5

Uttar Pradesh

17,10,028 9

119 10

16,87,011 19

22,898

West Bengal

15,80,530 624

7,421 24

15,54,132 634

18,977 14

Delhi

14,39,390 32

320 6

14,13,981 38

25,089

Odisha

10,35,077 443

4,542 68

10,22,250 508

8,285 3

Chhattisgarh

10,05,654 16

183 2

9,91,901 14

13,570

Rajasthan

9,54,390 2

42 2

9,45,394 4

8,954

Gujarat

8,26,290 10

207 6

8,15,997 16

10,086

Madhya Pradesh

7,92,684 5

84 12

7,82,077 17

10,523

Haryana

7,71,076 15

123 9

7,60,904 6

10,049

Bihar

7,26,026 5

48 4

7,16,317 1

9,661

Telangana

6,68,955 122

3,924 55

6,61,093 176

3,938 1

Assam

6,06,468 205

3,436 46

5,97,082 245

5,950 6

Punjab

6,02,035 27

227 8

5,85,264 16

16,544 3

Jharkhand

3,48,430 7

122 1

3,43,173 8

5,135

Uttarakhand

3,43,756 9

178 1

3,36,181 8

7,397

Jammu And Kashmir

3,31,062 95

843 12

3,25,793 107

4,426

Himachal Pradesh

2,21,437 131

1,303 5

2,16,414 125

3,720 1

Goa

1,77,522 60

604 6

1,73,572 62

3,346 4

Puducherry

1,27,396 52

585 13

1,24,961 64

1,850 1

Manipur

1,22,737 104

1,422 0

1,19,418 102

1,897 2

Mizoram

1,12,848 249

11,633 1,143

1,00,829 1,389

386 3

Tripura

84,321 16

104 4

83,401 12

816

Meghalaya

82,953 55

845 32

80,673 86

1,435 1

Chandigarh

65,302 3

25 3

64,457 6

820

Arunachal Pradesh

54,987 7

140 30

54,567 37

280

Sikkim

31,749 4

174 8

31,184 12

391

Nagaland

31,611 40

248 12

30,689 28

674

Ladakh

20,878 2

36 10

20,634 12

208

Dadra And Nagar Haveli

10,676 1

4 1

10,668

4

Lakshadweep

10,365

0 0

10,314

51

Andaman And Nicobar Islands

7,641

9 0

7,503

129

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