August 16, 2021 7:32:37 pm
Dr Sumitra Bachani, Associate Professor, Gynaecologist and Obstetrician Department, and a foetal medicine specialist, Safdarjung Hospital and Vardhaman Mahavir Medical College, explains the impact of Covid-19 during pregnancy and how a woman should take care.
Q. Are pregnant women more susceptible to developing severe Covid?
Pregnant women with symptomatic Covid-19 are at an increased risk of adverse pregnancy outcomes, including admission to the ICU, iatrogenic preterm birth, pregnancy-associated hypertension-like symptoms, operative intervention and even death. Also, there is a higher risk of developing Covid complications if a pregnant woman contracts the infection in the third trimester, which is the last three months of pregnancy. That is because the large uterus presses on the diaphragm and hampers the lung capacity thus making it more difficult for the woman to maintain oxygen saturation.
Pregnant women with certain high-risk conditions such as hypertension, diabetes, chronic respiratory conditions (COPD), asthma, cystic fibrosis, homozygous sickle cell disease, or those on immunosuppression therapies, dialysis or advanced chronic kidney disease, congenital or acquired heart disease and organ transplant recipients have greater risk of severe illness from Covid-19.
Q. If a mother catches Covid-19, does it affect the fetal or neonatal outcomes?
Whether an infected mother can transmit the infection to the foetus during pregnancy is a matter under research. To date, we have observed that mild to moderate Covid-19 infection in mothers does not affect the foetus or the newborn much. However, in severe cases, the foetus is at risk of perinatal morbidity due to hypoxia or low oxygen saturation, preterm birth, and mortality.
Q. Can a mother with Covid-19 infection stay with her newborn?
The mother and infant can stay together in the same room if the mother does not have severe Covid-19 which requires hospitalisation. Make sure that the room is well-ventilated and there is someone else also in the family who is Covid negative to take care of the infant. A mother should wear a mask and maintain a six feet distance from the child. However, she can breastfeed the child. Prior to handling the infant or while breastfeeding, the mother should wash her hands and wear a mask. She should also sanitise the surroundings regularly. Besides, the infant should not be made to wear a mask. Once the mother is non-infectious she can keep the baby with herself at all times.
Q. How important is the Covid vaccine for pregnant women and young mothers?
As I have mentioned above, a pregnant woman with symptomatic Covid-19 is at increased risk of adverse pregnancy outcomes and the foetus is also at risk of perinatal morbidity, and mortality. So, she should definitely take the vaccine. Experts say the benefits of vaccination outweigh the risk of morbidity and mortality associated with Covid-19, especially if contracted during pregnancy. Besides, there is an additional benefit—a vaccinated mother also passes the antibodies she develops post vaccination to the unborn foetus through blood as well as through breast milk to her neonate.
Q. In what conditions should a mother not take the vaccine?
Just like the general population, a pregnant woman too should avoid taking the vaccine if she has an anaphylactic or allergic reaction to the previous dose of Covid-19 vaccine or to other vaccines or injectable therapies, pharmaceutical products, food items, etc.
If she has recently been diagnosed with Covid-19 infection, she should wait for 12 weeks from the onset of infection or four to eight weeks from recovery from active Covid-19 infection for taking the vaccine. Or if she has been treated with anti-Covid-19 monoclonal antibodies or convalescent plasma recently.
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