covid-19 in pregnancy

1. COVID-19 in
Pregnancy

2. BACKGROUND
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3. OBJECTIVES
To discuss the effects of
COVID-19 throughout
pregnancy.
To review management
protocols of COVID-19 in
pregnancy at MCMH
To discuss challenges faced in
delivering obstetrics care
during the pandemic.

4. COVID-19?
Coronavirus disease 2019 is caused
by the severe acute respiratory
syndrome coronavirus (SARS-CoV-
2)
Transmission is primarily via direct
person to person contact.
Infected persons can be either
asymptomatic or symptomatic.

5. Symptoms of Covid-
19 in pregnant
women Pregnant women do
not appear more likely
to become infected
than the general
population.
Most women infected
with this virus are
asymptomatic.
Most symptomatic
women experience
mild to moderate
cold/flu like symptoms.
Mains symptoms are
cough, fever, sore
throat, dyspnea,
myalgia, loss of sense
of taste and diarrhea.

6. Severe illness
with Covid-19 in
pregnant women
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7. Risk factors for
hospital admission
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8. Risk factors for
hospital admission
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9. Effect of
Covid-19 on
pregnancy
Symptomatic infection is associated
with an increased likelihood of
iatrogenic pre-term birth.
Increased incidence of small for
gestational age babies.
Neonatal morbidity is linked to
preterm birth rather than the
infection itself.
Stillbirths remain a rare outcome,
but maternal infection is associated
with and increased risk of stillbirth.

10. Covid-19 vaccination in pregnancy
Vaccination is strongly recommended and can be given at
any time during pregnancy.
Pregnant women should be offered Pfizer-BioNTech or
Moderna vaccines.
Breastfeeding women can receive the vaccine.
Currently no evidence exists to suggest Covid-19 vaccines
affect fertility.

11. Management of Covid-19 in pregnancy at MCMH
A pregnant woman presents
to the Maternity
ward/outpatient department
• Does she have : cough,
fever, dyspnea, myalgia?
• Risk factors for severe
disease? Obesity, age ≥35,
pre-existing comorbidities
Initial assessment
• Covid-19 testing required
• SPO2 ≥94%
• RR ≤20

12. Management of covid-19 in
pregnancy at MCMH
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13. Management of covid-19 in pregnancy at MCMH
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14. Management of covid-19 in pregnancy at MCMH
Encourage
breastfeeding once
mother and
neonate are stable.
1
Continue VTE
prophylaxis for 10
days or until
discharge.
2
Consider prolonged
VTE prophylaxis for
women with
persistent morbidity.
3
POST DELIVERY

15. Management
of covid-19 in
pregnancy at
MCMH
Medications
• Prednisolone 40mg po od or
hydrocortisone 80mg bd
Steroids not for preterm
delivery
• dexamethasone 12mg x2 IM
24hrs apart
• continue prednisolone
Steroids for preterm
delivery

16. How did we
do in 2021?
No maternal deaths due to
SARS- Cov-2 infection.
No vertical transmission of
SARS-Cov-2 to neonates born
of infected mothers.
2 successful emergency/elective
Caesarian sections on Covid-19
positive mothers

17. CHALLENGES
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18. References
https://www.rcog.org.uk/
https://www.uptodate.com/
https://www.ncbi.nlm.nih.gov/

19. THANK YOU