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CUMED on COVID-19

CUMED on COVID-19

https://www.med.cuhk.edu.hk/covid-19/tips/health-tips/covid-19-and-pregnancy-what-you-should-know
https://www.med.cuhk.edu.hk/covid-19/tips/health-tips/covid-19-and-pregnancy-what-you-should-know

Coronavirus or COVID-19 and pregnancy: What you should know?

 

Please note that the information provided here is based on a small number of pregnant women with this infection. New information becomes available on a daily basis. We encourage you to talk with your doctor or midwife for the most up-to-date information.

 

請注意:到目前為止,只有少數孕婦感染過COVID-19,所以,此內容是根據目前僅有的資料來編寫,但相關資料會持續更新,您可以隨時向您的醫生或助產士查詢最新的資訊。
 

Q1: What is COVID-19?

COVID-19 is an infection caused by a novel coronavirus, a virus or bug similar to many of the viruses that cause the common cold. People with COVID-19 will typically have fever, tiredness, dry cough or feel short of breath. In some patients, the symptoms might get worse, they may have significant problems breathing and need to be admitted to the intensive care unit.

 

People with other long-term health problems like lung problems or ongoing diabetes are at higher risk of getting quite sick or developing severe lung problems. Their risk of dying is also increased.

 

Q1: COVID-19是什麼?

COVID-19是由一種新型冠狀病毒引致的傳染病。初期病徵與感冒症狀相似,包括發燒、乏力、乾咳和呼吸困難。部份患者病情會轉趨嚴重,出現嚴重呼吸困難,甚至需要入住深切治療部接受治療。

 

患者若有其他慢性疾病,如慢性呼吸道疾病、糖尿病等,他們出現重症或嚴重併發症,甚至死亡的風險會較高。

Q2: How does it spread?

The virus causing COVID-19 spreads mostly by contact with someone who is infected and sick or contact with objects they recently touched or sneezed or coughed on. The virus can be found in the saliva or the secretions from a runny nose. The virus enters the body by becoming in contact with the mouth, the nose or the eyes. The virus can also be spread by touching the bodily fluids, including feces, from patients.

 

Q2: COVID-19是如何傳播的?

COVID-19病毒會出現在患者的唾液和鼻液等分泌物及排泄物中,主要是經呼吸道飛沫傳播,通過接觸者的口、鼻或眼黏膜進入人體。病毒也可以藉接觸患者的分泌/排泄物或被這些分泌/排泄物污染的物件來傳播。

Q3: How can I avoid getting COVID-19?
  1. Washing your hands and use hand sanitizer regularly.
  2. Avoiding touching your face with your hands.
  3. Social distancing: staying at home as much as possible; If you must go out, staying at least 2 meters from others and wearing a surgical face mask are also good ways to avoid getting sick.
  4. To prevent passing any viruses to others, people should sneeze or cough while covering their mouth with tissue and not with their hand. Dispose of the soiled tissue appropriately.
  5. If you have symptoms, you must wear a surgical face mask and seek medical attention immediately.
     
Q3: 我怎樣才能避免感染COVID-19?
  1. 勤洗手:經常洗手或用酒精搓手液消毒雙手。
  2. 避免用手觸摸臉部。
  3. 保持社交距離:儘量留在家中,減少外出。如必須外出,應儘可能與其他人保持至少兩米距離,並佩戴外科口罩。
  4. 打噴嚏或咳嗽時要用紙巾掩着口鼻,並把用過的紙巾妥善棄置。
  5. 如有病徵,必需立刻佩戴外科口罩,並即時求醫。
Q4: Should I avoid going to the hospital or seeing my doctor or midwife for antenatal care?

You will have many appointments with doctors and midwives when you are pregnant. Those are important for your health and that of your baby and should only be missed after discussion with your doctor or midwife. You must wear a surgical face mask when you go to the clinic or the hospital. When you are in the clinic or the hospital, ensure strict hand hygiene by washing your hands with soap and water or using hand sanitizer regularly, avoid touching your face with your hands and try to stay at least 2 meters away from other people in the waiting area. You should wash your hands when you leave.

 

If you have any symptoms like a cough or you are sick with COVID-19, please contact the clinic or the hospital to see if it is better to keep your appointment or move it to a later date and to discuss a plan for future antenatal care visits.

 

Q4: 我應該避免去醫院和診所進行產前檢查嗎?

產前檢查對孕婦和胎兒的健康都很重要。如果您在懷孕期間遇到任何產科問題,或需要延遲/取消產前檢查,請與您的醫生或助產士聯絡。

 

當您前往醫院或診所時,必須佩戴外科口罩。在診所或醫院期間,要嚴格保持手部衞生,避免用手觸摸臉部,儘量與其他人保持至少兩米距離。離開前也必須緊記要先洗手。

 

如果您在產前檢查前出現呼吸道感染病徵或已經確診感染COVID-19,請預先致電醫院或診所,詢問是否需要把檢查延期或取消,並討論以後的產前檢查安排。 

Q5: Is it dangerous for me if I get COVID-19 when pregnant?

We have very little information about pregnant women who got sick with COVID-19. Based on the little information that we have, it seems that pregnant women do not get more sick with COVID-19 compared to women of the same age who are not pregnant. Women with other health problems, in particular lung problems, high blood pressure, diabetes or HIV are at higher risk of getting sicker.

 

If you are diagnosed with COVID-19, you will be admitted to the hospital for isolation and for close observations and appropriate treatments. At present, doctors do not have enough clinical experience and data to formulate medical measures specifically for the treatment of COVID-19 in pregnant women. Doctors may suggest an X-ray test be done. All necessary measures will be undertaken to make sure the X-ray is done as safely as possible for you and your baby. Paracetamol is a safe medication in pregnancy if you have a fever. If the COVID-19 infection is severe, you may need to give birth early. This is why close observations are necessary.

 

Q5: 如果我在懷孕時感染了COVID-19,會有危險嗎?

到目前為止,只有為數不多的婦女在懷孕期間受感染,所以有關孕婦感染COVID-19的臨床資料非常有限。根據現在掌握到的資料,患有COVID-19的孕婦與沒有懷孕的同齡婦女患者比較,她們病情惡化的風險沒有明顯增加。但跟其他COVID-19患者一樣,如果孕婦本身患有其他慢性疾病,特別是呼吸道疾病、高血壓、糖尿病或愛滋病等,她們出現嚴重併發症的風險則會較高。

 

如果您已被確診COVID-19,就必須立即入院隔離,避免與其他孕婦接觸,並接受緊密的醫學監察和適當治療。目前醫護人員沒有足夠的臨床經驗和數據去制定特別針對處理孕婦感染的醫療措施。一般來說,醫生可能會建議您進行X光檢查,並會採取必要的措施來確保您和胎兒的安全。如有發燒,paracetamol (必理妥) 是懷孕期間可以安全使用的藥物。因為重症孕婦患者可能需要提早分娩,所以她們需要特別緊密的醫學監察。

Q6: Is it dangerous for my baby if I get COVID-19 when pregnant?

Based on the limited information that we have, the virus does not seem to pass from mothers to babies during the pregnancy. There are no signs that COVID-19 increases the risks of birth defects, although we know of only a few women who have had the virus when this is the most dangerous and have since had their babies. A high fever in early pregnancy may increase the risk of miscarriage or be linked with a higher risk of problems with the spine and the brain in the baby. This is not specific to COVID-19 but comes with any reason for having a fever. This risk remains very low. Around 2 women for every 1000 women with a fever in early pregnancy may have a baby with this kind of problem, compared to 1 woman for every 1000 pregnant women who did not have a fever early in pregnancy. An ultrasound examination at 20 to 22 weeks is recommended to check for such problems.

 

Some studies of similar viruses have suggested that the baby may not grow as well after an infection similar to COVID-19. Most experts recommend at least one ultrasound 4 weeks after the end of the infection to make sure the baby is growing well. It is also recommended that regular ultrasound exams continue to be done every 4 weeks throughout the pregnancy to check on how the baby continues to grow.

 

The biggest risk for the baby is if you get very sick and go into labor well before your due date or the doctors or midwives recommend you deliver early because the baby is not doing well as a result of how sick you are. The closer you are to your due date, the fewer the risks for baby. Therefore, if you and your baby are stable, the doctor will recommend continuing pregnancy until the full term. There are no reasons at the moment to choose a Cesarean section instead of a vaginal delivery when a mother has COVID-19, unless another reason exists. In general, if you and your baby are stable, giving birth naturally is possible. But if the mother’s condition is serious, the doctor may recommend an assisted birth or a Cesarean section.

 

Q6: 如果我在懷孕時感染了COVID-19,胎兒會有危險嗎?

正如前面所說,我們目前沒有足夠資料去判斷孕婦會否把病毒傳染給胎兒,但暫時沒有跡象顯示孕婦感染了COVID-19會增加胎兒出現先天性缺陷的風險。一般來說,不論孕婦是否感染了 COVID-19,如果她們在早期懷孕時發高燒,胎兒流產或出現脊柱和腦部異常的風險可能會增加。研究顯示平均每1000名早期懷孕發燒的孕婦,大約有兩名會出現以上的問題,而每1000名沒有發燒的孕婦中只有一名會出現同樣問題。因此,在20 – 22週期間進行胎兒結構超聲波檢查尤其重要。

 

研究亦發現如果孕婦感染了類似COVID-19的病毒,胎兒可能會出現宮內生長遲緩的問題。大多數專家都會建議孕婦在感染痊愈後四週進行一次超聲波檢查,之後定期每隔四週重覆檢查,以確定胎兒生長正常。

 

對胎兒來說,最大的風險可能是因孕婦病情惡化而導致胎兒需要提早分娩,引致早產,分娩時間越早,早產對新生兒造成的問題就越大。所以,如果孕婦和胎兒的情況穩定,醫生會建議繼續懷孕,直至足月。生產方法方面,一般來說,如果產婦和胎兒情況穩定,可以自然分娩。但如果產婦病情嚴重,醫生可能會建議輔助或剖腹生產。

Q7: Does my baby need to be separated from me soon after birth if I have COVID-19?

Different regions will act differently based on local availability and the local situation with COVID-19. To avoid spreading the virus to the baby, you may need to be separated from the baby temporarily, but you should check with your doctor or midwife for details.

 

Q7: 如果我確診COVID-19,我要與BB分開嗎?

不同國家和地區會根據當地的情況和可行性而採取不同的做法。為了避免將病毒傳染給嬰兒,您可能需要暫時與嬰兒分開,但具體情況您要向醫生或助產士查詢。

Q8: Can I breastfeed if I have COVID-19?

Based on the limited information that we have, a few women infected with the virus had their breastmilk tested and no sign of the virus was found in the milk. So, it appears safe to feed your breastmilk to your baby even if you have COVID-19. You should be careful to avoid passing on the virus to your baby. This is best done by pumping the breastmilk and have someone who is not sick feed it to the baby. If you pump your milk, make sure you wash your hands before doing so and wear a face mask to prevent inadvertent contamination. Be sure to clean the breast pump thoroughly after each use.

 

Q8: 如果我感染了COVID-19,可以餵哺母乳嗎?

初步研究顯示在COVID-19患者的母乳中沒有發現病毒。所以,即使您感染了COVID-19,根據目前有限的資料判斷,餵哺母乳仍是安全的。但為了防止您把病毒傳給的嬰兒,可以選擇「泵奶」,然後讓沒有患病的人把泵出來的母乳餵給嬰兒。泵奶的過程,務必要保持雙手清潔。在每次使用泵奶器後,請務必進行徹底清潔。

Q9: What if someone in the house has symptoms of COVID-19 after my baby is born?

The virus spreads mostly by contact with someone who is infected and sick or contact with objects they recently touched or sneezed or coughed on.  Babies must therefore also observe social distancing rules for protection. Avoid taking your baby to unnecessary social gatherings and do not invite high risk visitors into your home. Relatives with high risk travel history, symptoms like fever and cough or history of contact with COVID-19 patients should avoid visiting your baby for at least 14 days.

  

If the carer of the baby is unwell and there is no one else available to take care of the baby, then ensure that the carer wears a surgical face mask and observes strict hand hygiene before and after touching the baby or the baby’s immediate surroundings or equipment. Coughs and sneezes can project droplets to distances beyond 2 meters and carers or visitors must cover their mouths and noses if coughing or sneezing cannot be avoided and wash their hands thoroughly afterwards. 

  

If baby develops signs of infection, e.g., fever, reduced appetite, cough, short of breath or sleepiness, you should consult with a doctor to assess your baby.

 

Q9: 如果嬰兒出生後,家裡有人出現COVID-19徵狀,我該怎麼辦?

COVID-19主要是經飛沫和接觸傳播,所以,嬰兒也需要與其他人保持社交距離。您應避免帶嬰兒出席大型聚會,並避免讓高風險人士到訪您家。如親友從高風險地區回港、出現呼吸道感染症狀或曾接觸確診患者,都必須在最少十四天內避免接觸嬰兒。

 

如嬰兒的照顧者感到不適,但又沒有其他人可以代替,照顧者必須經常佩戴外科口罩,並在接觸嬰兒、其所處的環境及嬰兒的用具前後,嚴格保持手部衞生。由於咳嗽和打噴嚏時所噴出的飛沫可以遠達兩米以外的距離,照顧者或訪客在無可避免要咳嗽和打噴嚏時,必須要用紙巾掩蓋口鼻,並立即徹底清潔雙手。

 

倘若嬰兒出現感染症狀,例如發燒、食慾下降、咳嗽、呼吸急促和嗜睡等,應儘快帶嬰兒前往求醫。

 

 

If you have any other questions, please contact your doctor or midwife.

The above update date is April 2, 2020

 

如有其他問題,歡迎向您的醫生或助產士查詢。

上內容更新日期為2020年4月2日

 

 

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