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CUMED on COVID-19
CUMED on COVID-19https://www.med.cuhk.edu.hk/covid-19/tips/health-tips/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.
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.
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.
Q3: How can I avoid getting COVID-19?
- Washing your hands and use hand sanitizer regularly.
- Avoiding touching your face with your hands.
- 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.
- 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.
- If you have symptoms, you must wear a surgical face mask and seek medical attention immediately.
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.
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.
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.
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。
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.
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.
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.