Covid -19 is a viral disease that first appeared in China and spread rapidly all over the world, and was declared a worldwide pandemic by the World Health Organization (WHO).
The rapid spread of the disease, the lack of a definitive treatment or protective vaccine, and the fact that it causes an increasing number of deaths worldwide increase the impact of the disease.
During pregnancy, there are changes in our immune system, as well as in our entire body. . In the light of current data, no increased sensitivity has been detected in pregnant women compared to the general population.
The virus can be transmitted from sick individuals through droplets, that is, from surfaces contaminated with secretions such as coughing and sneezing, and by contact with the patient's hand and the eye, mouth and nose mucosa. It is known that droplets do not travel further than 2 meters. The disease can also be transmitted from people who have no complaints, which we call asymptomatic.
The symptoms of the disease are fever, cough and shortness of breath. In severe cases, it can lead to pneumonia, respiratory failure syndrome, multiorgan failure and death.
Diagnosis is made by the PCR method of swab samples taken from the upper respiratory tract. Testing should be repeated in cases with symptoms whose first test was negative. If both test analyzes are negative, COVID-19 is excluded.
Although there is no vaccine or definitive treatment for the disease yet, the algorithm announced by the Ministry of Health recommends the use of hydroxychloroquine and lopinavir/ritonavir. Hydroxychloroquine is used in the treatment of malaria and rheumatic diseases in pregnant women, and no significant negative effects have been detected.
It is known that the lopinavir / retinovir combination does not increase the frequency of anomalies in the baby.
A finding showing that pregnant women are more sensitive to COVID-19. However, the number of data we have right now is limited. It has not been observed to cause congenital abnormalities in the womb. Based on the limited findings we have, no mother-to-baby transmission (vertical transmission) has yet been observed. No maternal deaths have been reported at the moment.
HOW SHOULD THE MANAGEMENT BE DURING PREGNANCY?
Early isolation of suspected patients, infection tests (covid 19) and others (H1N1). is property. The patient should be placed on oxygen therapy. Excessive fluid load should be avoided. Fetus monitoring should be done. In case of progressive respiratory failure, individual birth timing should be made according to the week of pregnancy. Infectious diseases specialists should be consulted before steroid treatment, which is frequently applied for the baby's lung development.
Pregnant women should limit visiting or traveling to risky places and wear masks in hospitals and high-risk places. In case of suspected contact, the patient must be quarantined for 14 days. No visitors should be allowed in the house and the room where the pregnant woman stays should be well ventilated. It should be isolated as much as possible from other members of the household. Examination should be postponed, except for emergencies, until the required isolation period (14 days) after a suspicious contact has expired.
There is no clear recommendation on the method of delivery, and in the reported series, births were largely performed by cesarean section, and the reason for this is the role of respiratory distress in pregnant women. There is no data showing that patients with Covid-19 cannot give birth normally. All babies should be tested for COVID-19 after birth.
There is currently no evidence that the virus will be transmitted through breast milk. The risks of close contact between mother and baby should be decided by the multidisciplinary team based on the benefit and harm relationship.
Hands should be washed before breastfeeding. Hands should be washed and disinfection rules should be followed before touching all feeding products such as milking pumps and feeding bottles.
A face mask should be worn while feeding the baby at the breast. Sterilization rules must be strictly followed.
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