Pregnancy in a pandemic – risks and complications. Expert opinion

Alla Pashkova

“What happens if I get coronavirus? How does this disease occur in pregnant women? ” – These and many other questions are asked by the woman who is carrying a child. To dispel their fears and doubts, StarHit turned to the doctor obstetrician-gynecologist of the hospital Eramishantseva, candidate of medical sciences Alla Pashkova.

By the way, Alla Valerievna quite successfully develops her blog in Instagram – At the moment, more than 978 thousand users are subscribed to it.


Today I often hear from acquaintances: “It’s good that I’m not pregnant in a pandemic, they say, in hospitals it is not clear what’s going on.” What do you say about this? Should couples postpone baby planning for a more favorable period?

Alla Pashkova

This is everyone’s business. You must understand that the vaccine will be created only at least a year later. It is important not only to create it, but also to test it on animals, and only then to investigate safety in humans. I will cite the data available at the moment, and the pair will make the choice themselves. I will appeal only to confirmed sources. The percentage of mortality from coronavirus infection in pregnant women is up to 25%. It has been proven that the virus causes severe complications during pregnancy, including the need for mechanical ventilation (mechanical ventilation), leads to renal failure and even death. The highest risk group for severe SARS-CoV complications in pregnant women is women with chronic lung diseases, including moderate to severe asthma, diseases of the cardiovascular system, including arterial hypertension, diabetes mellitus, immunosuppression (for example, cancer treatment), obesity with a body mass index of more than 40, chronic diseases of the kidneys, liver. If one of the future parents, and even more so two, has these diseases, we should definitely think about the advisability of planning. And, of course, the most ideal option is if both partners or at least the expectant mother have already been ill with the coronavirus. In this case, they will have antibodies – then planning a pregnancy is not scary.


How is coronavirus in pregnant women?

Alla Pashkova

In part, I answered this question above, but can be supplemented. In fact, in every third pregnant woman the virus is asymptomatic. A mild to moderate course was detected in 55-80%. A severe course with hospitalization in the intensive care unit is in every tenth and an extremely severe course is in 3-5%. A study conducted this year showed that complications in pregnant women with COVID-19 included miscarriage (2%), fetal growth retardation (10%), and premature birth in 39%.

In most cases, coronavirus in pregnant women is easy if there are no chronic diseases

In most cases, coronavirus in pregnant women is easy if there are no chronic diseases


Does the virus affect the health of the future baby?

Alla Pashkova

It is not known exactly whether a pregnant woman can transmit the virus to her baby during pregnancy and childbirth. According to recent data, the virus was not detected in samples of amniotic fluid, placenta and breast milk. Documented neonatal infections have been associated with close contact with the mother or persons infected with COVID-19 and caring for the newborn.

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Have you experienced pregnant women infected with COVID-19 in your practice?

Alla Pashkova

Currently, pregnant women with coronavirus receive medical care in the following maternity hospitals in Moscow: Inozemtseva, Demikhova and IKB 2. I work in the Eramishantseva and Iudina in the maternity ward – these are maternity wards targeted at healthy women and newborns.


How to treat coronavirus? Is there a cure?

Alla Pashkova

While there is no such pill or medicine that could cure this virus. You can protect yourself from it by having the appropriate antibodies in the blood. And this is possible in the following ways – to get sick, get them with a vaccine (ready-made antibodies or in the form of a weakened virus, which helps to develop their own antibodies) or by transfusion of the plasma of a donor who has had coronavirus.


If a woman is in the first trimester, and she has a severe form of COVID-19 – do they keep the pregnancy?

Alla Pashkova

The main indication for termination of pregnancy up to 12 weeks is the severity of the pregnant woman in the absence of the effect of the therapy. In severe and moderate cases of the disease up to 12 weeks, due to the high risk of perinatal complications associated with both the direct exposure to a viral infection (high temperature) and the embryotoxic effect of some drugs, pregnancy may be terminated after the infection process has been cured. If the patient refuses – from 10 weeks to exclude the fetal chromosomal pathology, a non-invasive test or invasive diagnosis is possible – from 12-14 weeks – chorionic villus sampling or amniocentesis – from 16 weeks.

During this difficult time, couples are better off planning a pregnancy

During this difficult time, couples are better off planning a pregnancy


How are births performed in patients with coronavirus and is COVID-19 an indication for cesarean section?

Alla Pashkova

The presence of COVID-19 is not an indication for early delivery, with the exception of a condition requiring improvement in the level of oxygenation of the pregnant woman (that is, a severe form of coronavirus with no effect of the therapy). The term and method of delivery is selected individually depending on the clinical condition of the woman, gestational age and condition of the fetus. Indications for calling for childbirth are determined individually depending on the severity of the patient’s condition and, if possible, it should be postponed if this is not associated with a deterioration in the condition of the mother.


Why can’t a coronavirus mother breastfeed?

Alla Pashkova

All documented cases of infection of the newborn were associated with the infection of a healthy newborn from a sick mother after childbirth. But no one talks about suppressing lactation. The latest recommendations on coronavirus infection suggest that during the diagnosis of COVID-19, treatment and quarantine measures, a separate stay of the mother and the child is recommended. It is reasonable, as well as the fact that no mother wants to intentionally infect a baby. Breast milk contains antibodies that protect the newborn, but not in the amount to completely protect him from infection. The mother expresses milk in compliance with all aseptic and antiseptic measures, and healthy personnel feed the baby with expressed milk until a mother receives a PCR smear. At the same time, lactation is not suppressed, and the child does not become an artificial person. The resumption of breastfeeding is possible after receiving two negative tests for COVID-19 in both the mother and the baby.


How can pregnant women maintain immunity and not worry at such a difficult time?

Alla Pashkova

The most important thing is effective self-defense and self-isolation. Better to prevent than to cure. I will not be original, but I repeat: the situation is gradually leveling out, we are learning to live in new conditions, but for now it is better to stay at home or go with the family to the country (if, of course, there is an opportunity). Remember that when going to a store or public places, you must observe the following rules: wear a mask (change it every 2-3 hours), do not touch the mask, face or hair with your hands. Wear gloves or use alcohol sanitizers. Do not touch door handles or elevator buttons with bare hands. Be sure to wash your hands thoroughly with soap for at least 20-30 seconds, if this is not possible, then use an alcohol sanitizer, maintain a distance of at least one, and preferably four meters, monitor the nutrition and balance of microorganisms in the gastrointestinal tract. It is advisable to drink a sufficient amount of liquid, eat food with a minimum content of easily digestible carbohydrates, do not forget about the daily intake of potassium iodide and vitamin D3. I wish everyone not to get sick, but for pregnant women – also easy pregnancies, childbirth and healthy children!

Photo: personal archive, Pixabay.com

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