ICMR: Guidance for Management of Pregnant Women in COVID-19 Pandemic

Pregnant women do not appear more likely to contract the infection than the general population. However, pregnancy itself alters the body’s immune system and response to viral infections in general, which can occasionally be related to more severe symptoms and this will be the same for COVID-19. Transmission  With regard to vertical transmission (transmission from mother to baby antenatally or intrapartum), emerging evidence now suggests that vertical transmission is probable, although the proportion of pregnancies affected and the significance to the neonate has yet to be determined.  At present, there are no recorded cases of vaginal secretions being tested positive for COVID-19.  At present, there are no recorded cases of breast milk being tested positive for COVID-19. Effect on Foetus  There are currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19.  There is no evidence currently that the virus is teratogenic. Long term data is awaited.  COVID-19 infection is currently not an indication for Medical Termination of Pregnancy. General Guidelines for Obstetric Health Care Providers  Ob-gyns and other health care practitioners should contact their local and/or state health department for guidance on testing persons under investigation and should follow the national protocol.  Health care practitioners should immediately notify infection control personnel at their health care facility and their local or state health department in the event of a PUI for COVID-19.  A registry for all women admitted to with confirmed COVID-19 infection in pregnancy should be maintained. Maternal and neonatal records including outcome should be completed in detail and preserved for analysis in future.  Health care providers should create a plan to address the possibility of a decreased health care workforce, potential shortage of personal protective equipment, limited isolation rooms, and should maximize the use of telehealth across as many aspects of prenatal care as possible.  Each facility should consider their appropriate space and staffing needs to prevent transmission of the virus that causes COVID-19.  Pregnant women should be advised to increase their social distancing to reduce the risk of infection and practice hand hygiene.  Health care practitioners should promptly notify infection control personnel at their facility of the anticipated arrival of a pregnant patient who has confirmed COVID-19 or is a PUI so that infection control measures can be kept in place.  Intrapartum services should be provided in a way that is safe, with reference to minimum staffing requirements and the ability to provide emergency obstetric, anaesthetic and neonatal care where indicated. To read complete guidelines- https://icmr.nic.in/sites/default/files/upload_documents/Guidance_for_Management_of_Pregnant_Women_in_COVID19_Pandemic_12042020.pdf



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