This document discusses COVID-19 and its effects on pregnancy. It notes that pregnant women are not more susceptible to COVID-19 complications unless they have comorbidities. The document outlines recommendations for pregnant women to prevent COVID-19 exposure, describes clinical presentation of the virus, and provides guidance on antenatal care, labor and delivery, breastfeeding, and care of newborns if the mother has COVID-19.

1. Pregnancy and COVID-19

2. COVID-19 short brief

3. COVID-19
 Coronavirus are family of enveloped, single-stranded RNA viruses cause mild
symptoms like common cold.
 At the end of 2019. coronavirus was identified in a worker in Wuhan Sea food
market in the Province of China who had pneumonia.
 It was observed that strain is virulence and quickly passed from human to
human.
 In Jan 2020. WHO designed COVID-19 as a pandemic
 It designed this virus as 2019 Novel Corona virus- later on it renamed as
severe acute respiratory syndrome coronavirus 2
( SARS-CoV-2): previously it was referred to as 2019-nCoV.

4. COVID-19
 2002: Severe acute respiratory syndrome Coronavirus (SARS-CoV)
 2012: Middle East respiratory syndrome Coronavirus (MERS-CoV)
 2019: named SARS-CoV 2
 2020: in Feb, WHO designed the disease Covid-19 which stands for
Coronavirus disease 2019.

5. 02

6. Disease Severity Category
CRITICAL
Respiratory failure, shock
or multiorgan dysfunction
SEVERE
dyspnea, hypoxia or >50 %
lung involvement on
imaging
MILD
MODERATE
No or mild pneumonia

7. Pregnancy
and
COVID-19

8. COVID-19 in pregnancy
Pregnant women are not more susceptible to consequences of COVID-19.
But if they have co-morbidities like
DM/ HTN/ Asthma /Heart disease /Liver /Kidney disease
/Immunosuppression.

9. Risk of infection in
pregnant women
Studies shows different results

12. March 15th, 2020

19. Prevention
Pregnant women should follow the same recommendations as non
pregnant persons to avoid exposure to COVID-19.
DO THE FIVE :
 Home
 Hands
 Elbow
 Space
 Face

21. Clinical Presentation
• The mean incubation period is 5-7 days
• Fever >38 C
• Cough
• GI symptoms: vomiting, diarrhea
• Difficulty in breathing
• Anosmia
• Loss of taste

22. Antenatal care

23.  Isolation measures, supportive treatments should be applied following the MOH
corona virus disease 19 guideline.
 Any pregnant woman diagnosed with COVID-19 disease will not attend to antenatal
clinic till she is cured.
 Routine antenatal clinic appointments can be delayed till patient is cured
 COVID-19 is not known to cause fetal congenital anomalies
 Serial ultrasounds every 4 weeks for fetal anatomy and fetal wellbeing starting from
24 weeks of gestation is advisable

24. Labour & delivery

25.  Delivery should occur in an isolated room and the room should be disinfected right after the
patient is discharged to the ward following the infection control measures
 Continuous fetal monitoring during labour.
 Normal vaginal delivery with delaying rupture of membranes is advised.
 Caesarean section is for obstetrical reasons.
 Operative vaginal delivery is not contraindicated
 Labor, delivery and recovery should be done in the same room.
 Caregivers handling a patient with corona virus should change all their clothing’s (if they are
not wearing protective gowns and head cover) and wash hands before handling another
patient( kindly referee to the infection control policies and MOH COVID -19 disease guidelines) .

26.  New born babies of covid-19 infected mother should not be allowed to be in contact with their
mother’s till the mother is cured or declared free of the disease (following the current
isolation measures in MOH OCVID-19 disease guidelines )
 Isolation of those babies till they are declared clear from the virus or for 14 days
 If the new-born is tested positive for covid-19, it should be kept in isolation until it is cured or
test negative.
 Transfer a new born from delivery room: a gentle bath with warm water and soap should be
done
 Placenta should be kept in a container that will be washed before handling to responsible
department and labelled according to the infections control policies.
 No relatives should be allowed into the delivery room
 Pregnant patients with suspected covid-19 infection will be dealt with as if they are infected.

27. Breast feeding

28.  Mother breast milk is the best nutrition to a new-born.
 Direct breast feeding is not advisable (risk of direct infection with close
 contact)
 Extracted breast milk can be fed to the infant using milk bottles with the
 help of another person if possible
 PrecautionarymeasuresaretobestrictlyfollowedasperMOHCOVID-19
 guidelines and it includes : washing hands and breast – wearing a face mask – using a clean
breast pump – clean the surface of the milk collection container – another person to feed the
baby
 If mother isolation is not required and breast pump/ milk extraction is not feasible then the
patient can be allowed to breast feed with taking inconsideration the previous protectionary
measures with the addition of a protective sheet between the mother and the baby.

32. SUMMARY

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Stay safe and
always take
care