COVID-19 during pregnancy, delivery and postpartum period based on EBM

Abstract

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the reason of the global health crisis. Since the first case of diagnosed COVID-19 pneumonia was reported in Wuhan, Hubei Province, China, in December 2019, the infection has spread rapidly to all over the world. The knowledge gained from previous human coronavirus infection outbreaks suggests that pregnant women and their foetuses represent a high-risk population during infectious disease epidemics. Moreover, a pregnancy, due to the physiological changes involving immune and cardiopulmonary systems, is a state predisposing women to respiratory complications of viral infection. The constantly increasing number of publications regarding the course of COVID-19 infection in pregnant women has been published, however, the available data remains limited and many questions remain unanswered. The aim of this review was to summarize the literature data and adjusted to current recommendations regarding pregnancy care, delivery and postpartum period. An extremely important issue is the need to register all the cases of COVID-19 affected women and the course of these pregnancies to local, regional, or international registries, which will be helpful to answer many clinical and scientific questions and to create guidelines ensuring an adequate level of care for women affected by COVID-19 infection during pregnancy, delivery and during postpartum period, as well as their newborns.

Cytokine Storms in the Course of COVID-19 and Haemophagocytic Lymphohistiocytosis in Pregnant and Postpartum Women

“…The severity of the disease in the general population and in pregnant women appears to be comparable (mild-86%; severe-9.3%, critical-4.7%) [36].…”

Chest imaging in pregnant patients with COVID-19: Recommendations, justification, and optimization

“…If there is a positive pulmonary embolism, deep vein thrombosis, or when there is maternal hypoxemia, an obstetric ultrasound for fetal growth, amniotic fluid, and color Doppler imaging should be performed when necessary to assess the extent of fetal hypoxemia. 52 …”

Management of birth, postpartum care and breastfeeding — Polish recommendations and guidelines during SARS-CoV-2 pandemic

“…• In the most recently updated national obstetrics, gynecology, and perinatology consensus, issued on 14 th May, it is written that because the risk of vertical and intranatal SARS-CoV-2 transmission seems to be low [9,10], the SARS-CoV-2 infection is not the main indication to perform cesarean section currently. Under the obstetrician's consideration remains the final decision (the local wards and staff work organization and patient's clinical situation as well) [10].…”