Every day, the number of people infected with the coronavirus is increasing. Most cases are harmless, but there are also risk groups. Pregnant women are not one of them, but questions still arise for many at the moment.
If you fall ill with the new coronavirus SARS-CoV-2, doctors speak of the disease Covid-19 (Corona Virus Disease 2019). The symptoms of the disease usually resemble a harmless cold. Symptoms include: fever, cough, shortness of breath, muscle pain and tiredness – sometimes sputum, headache and diarrhea. A minority contracted viral pneumonia, the severe course of Covid-19. There are now reliable tests that can be used to diagnose an infection by the coronavirus.
Who is at risk from the coronavirus?
According to previous knowledge, the sex, age and state of health of a patient play a decisive role in whether you get the severe form of Covid-19. It is assumed that older people in particular – and especially men – are affected and people with chronic diseases. In addition, long-term smokers have an increased risk of developing Covid-19. Children and pregnant women are less at risk. Although pregnant women are considered less at risk, they are particularly concerned for themselves and their offspring.
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Are pregnant women particularly at risk from the coronavirus?
According to the press release of the Professional Association of Women’s Doctors, it is assumed that the vast majority of pregnant women will only experience mild or moderate symptoms – comparable to those of a cold or a flu-like infection. It looks different if the pregnant woman suffers from a heart or lung disease. Then, as with other people with previous illnesses, complications are more likely.
Does coronavirus infection affect the unborn baby?
The virus is so new that there is not enough experience. However, according to the professional association of gynecologists, there are no indications of an increased risk of miscarriages. It is therefore also considered unlikely that the virus will cause permanent damage to the fetus.
In the context of the CRONOS register of the German Society for Perinatal Medicine (DGPM), in which 118 German clinics participate, 137 pregnant women who tested positive for SARS-CoV-2 have already been registered (as of July 10, 2020). Of these, 88 women have already had their children, of which only five children tested positive for SARS-CoV-2.
Daniele de Luca and his colleagues from the University Hospitals of Paris Saclay, in Clamart, France, presented the results of a first case study in Nature Communications on July 14, 2020, which indicates that SARS-Cov-2 transmission via the placenta is possible .
The mother had previously tested positive for the virus. Smears also showed positive results from a coronavirus infection in the baby and neurological abnormalities that are similar to those of adult patients.
SARS-CoV-2 transmission possible via the maternal placenta
What can be done to reduce the risk of infection with the coronavirus?
80 percent of all infectious diseases are spread through the hands. This is often made easy for them. Because we touch our faces every four minutes, often with unwashed hands. This is THE chance for viruses to spread through our mucous membranes.
This is why frequent hand washing is more important than ever to reduce the risk of infection – for at least 30 seconds. In addition, any contact with anyone, including family, who has symptoms of a cold or fever should be avoided.
What to do if you have had contact with people with Covid-19?
If you have symptoms of a coronavirus infection, contact your gynecologist – by phone! They should clarify the next steps with you. In addition, contact your local health department immediately and regardless of symptoms, or call the medical on-call service on 116117. No treatment options or vaccinations are currently approved. The diagnosis is made with a smear test from the mouth and throat area.
What to do if you test positive for the coronavirus?
If you test positive for the coronavirus, you should contact your gynecologist by phone. If your symptoms are mild and you or your family do not present any risk factors, you can relax at home and receive care from a doctor. If you have more severe symptoms you may be treated in hospital.
When should you be isolated?
Isolation is recommended, according to the professional association of gynecologists, if:
- You have come into contact with someone who has a coronavirus infection
- You have visited a specific area or country in which Covid-19 cases occur or which has been designated as a risk area
- You have symptoms suggestive of coronavirus infection and are waiting to be tested or for your results
- You tested positive for the coronavirus and were advised to recover at home.
Criteria for lifting isolation measures
According to the current state of knowledge, lifting the isolation at home or discharging from the clinic is justifiable at the earliest ten days after the onset of symptoms and fulfillment of these criteria:
- Fever-free for at least 48 hours
- Symptom-free for at least 24 hours related to the acute Covid-19 illness
- as well as 2 negative SARS-CoV-2-PCR examinations at an interval of 24 hours obtained from mouth and throat swabs.
What should I do if I am asked to self-isolate?
Pregnant women who have been advised to self-isolate should stay indoors and avoid contact with others for 14 days. The Robert Koch Institute (RKI) gives specific recommendations on this.
In concrete terms this means:
- Not going to school or work or public areas.
- Do not use public transport – stay home and do not allow visits.
- Ventilate the rooms in which they are located.
- As much as possible, separate yourself from other people in the household by using their own towels, dishes and utensils, and eating at different times.
- Ask friends and family or use delivery services to run errands for you. The handover should then take place without direct contact.
- What about in the case of cases with prenatal check-ups?
- If you are in isolation at home, you should contact your gynecologist and inform him about it. Usually, routine prenatal appointments can be postponed without harm to you or your child.
Does self-isolation affect childbirth?
At this point in time, there is nothing to suggest that pregnant women with suspected coronavirus or coronavirus infection cannot give birth vaginally or that a caesarean section is safer. There is also no evidence that one should not give a PDA.
However, the use of nitrous oxide can increase the aerosolization and spread of the virus – we strongly advise against this.
The situation is different when a respiratory disease (breathing) indicates that an urgent delivery is required. Then a caesarean birth can be recommended.
Will my baby be tested for the coronavirus?
Yes, if you are suspected or confirmed to have coronavirus infection at the time your baby is born, your baby will be tested for the coronavirus.
Can infected women breastfeed their baby?
Yes. There is currently no evidence-based evidence that the virus can be transmitted through breast milk. Only one case was reported in which the RNA (ribonucleic acid) of the virus was found in breast milk and the child contracted COVID-19. However, it is unclear by which mode of transmission the infant became infected.
Therefore, it is believed that the recognized benefits of breastfeeding outweigh the potential risks of coronavirus transmission. Infected mothers or suspected cases of breastfeeding should prevent transmission of the virus through droplet infection by taking hygiene measures such as thorough hand washing before and after contact with the child and by wearing a face mask. This recommendation may change as knowledge about the new virus evolves.
When breastfeeding your baby, precautions are recommended:
- Wash your hands long enough before touching your baby, breast pump, or bottle.
- Wear a feeding face mask on your chest.
- Follow the pump cleaning recommendations after each use.
- If you plan to feed your baby with formula or milk, it is recommended that you strictly follow the sterilization guidelines.
- When expressing breast milk in the hospital, a special pump should be used.
- If a mother is unable to breastfeed her child, the breast milk can also be expressed and fed to the infant via another person. Here, too, attention should be paid to hygiene and the pump and bottle should be sterilized after use.