Pregnancy is a state of partial immunosuppression, and pregnant women are more prone to viral infections and morbidity is higher even in seasonal flu. It has been proven that the virus can pass from person to person, even from patients with no symptoms, and its effect is significant, especially in elderly patients and patients with comorbidities. Information regarding the management of pregnant women and newborns with COVID-19 is based on limited clinical experience. There are no pregnant deaths reported so far. If infection occurs in the third trimester of pregnancy (last 3 months of pregnancy), there is some increased risk for premature rupture of membranes, premature birth, fetal heart rate abnormalities. However, there is no evidence of transfer through the placenta. Since COVID-19 still continues to spread, it is important for pregnant women and their relatives, the public and healthcare professionals to receive as accurate information as possible.
Preventing CoVid-19 infection during pregnancy
People infected with COVID_19 even without symptoms. They can spread the virus through close contact and droplets. During the epidemic, pregnant women are more prone to COVID-19 infection due to physiological changes in their immune and respiratory systems. There is currently no effective vaccine. Therefore, pregnant women should avoid unnecessary travel, avoid crowded places, avoid using public transportation, avoid contact with sick people, and most importantly, pay attention to their personal and social hygiene. Pregnant women who complain of fever, cough, fatigue, muscle pain, sore throat or shortness of breath should immediately consult a healthcare provider. Pregnant women with a history of travel to endemic areas and clinical suspicion of infection should be isolated and investigated.
General recommendations for pregnant women;
• Even if you are infected with COVID-19, you will mostly either have no complaints or completely You will have a mild illness from which you will recover.
• If your symptoms worsen or do not improve, be sure to contact the healthcare team. This may be a sign of a severe lung infection that will require more serious care.
• If you are in good condition, contact your physician for your routine pregnancy follow-ups, because your routine check-ups must continue.
• Be sure to be in contact. limit the number of people you are with pus. Follow general protection rules.
Symptoms of CoVid-19 (Corona virus) infection during pregnancy
Clinical findings are fever, fatigue, muscle pain, dry cough and shortness of breath. Some patients may experience nasal congestion, runny nose, sore throat or diarrhea. More serious conditions such as pneumonia (lung infection) and respiratory failure are generally described in people who are very old, have a weak immune system, and have a chronic disease such as diabetes, cancer, chronic lung disease.
CoVid-19 (Corona virus) in pregnancy Effects of ) infection on the fetus
The increased risk of miscarriage and early pregnancy loss associated with COVID-19 has not been stated. An increased risk of miscarriage and pregnancy loss due to infection was not reported in SARS and MERS, which are previous coronavirus infections. Likewise, since there is no evidence of infection in the baby in the womb, it is not thought to have any effects on fetal development. Premature births have been reported in women with COVID-19, but it is not clear whether this EARLY birth occurs spontaneously or due to infection.
Treatment of CoVid-19 (Corona virus) Infection During Pregnancy
COVID-19 Suspected pregnant women should be isolated and investigated. Those diagnosed with infection should be immediately taken to negative pressure isolation rooms, preferably those with serious conditions should be treated in multi-disciplinary hospitals that have the facilities to manage risky pregnancy cases.
Timing and Mode of Birth in Pregnant Women with Corona Virus Disease
The timing of birth should be individualized depending on the severity of the disease, gestational age and fetal status. In mild and stable cases that respond to treatment, pregnancy can be followed until term under close monitoring. In critical cases, continuing the pregnancy may endanger the life of the mother and the baby. In these cases, the baby should be delivered even if it is premature. The method of delivery should be decided according to obstetric indications. When birth by cesarean section is required, the choice of anesthesia should be made carefully. Since there is no evidence of vaginal spread of the virus and its transmission from mother to baby, vaginal birth may be considered in stable patients.
Postnatal Approach in Pregnant Women with Corona Virus Disease
There is no information regarding the transmission from the pregnant woman to the fetus before birth. r. Guidelines recommend that babies who do not need care for any other reason should be kept with their mothers.
• The most important risk for babies is the risk of infection due to close contact. However, data show that breastfeeding is superior to the risk of viral transmission through milk. Women who want to breastfeed should wash their hands before touching the baby, avoid coughing and sneezing, and wear a mask while breastfeeding.
Care of the newborn born to a mother infected with CoVid-19
Neonates may become infected by close contact. Early cord clamping and temporary separation of the newborn from the mother for 2 weeks are recommended to reduce the possibility of virus transmission from mother to baby. The newborn should be monitored in the isolation room and closely monitored for signs of infection. Breastfeeding is not recommended during this period. The mother's milk can be expressed and given to the baby.
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