COVID-19
(coronavirus disease 2019) is a respiratory illness that can be
serious. It is caused by a newly identified virus called severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2).
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Based on available information, the risk of getting COVID-19 and/or its causing severe symptoms seems to be the same for pregnant women as for other adults.
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The risk of problems during pregnancy (such as preterm labor, birth of a premature newborn, and preeclampsia) may be increased if symptoms are moderate or severe.
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Doctors suspect COVID-19 based on symptoms and the likelihood of exposure, but tests are needed to confirm the diagnosis.
The risk of a pregnant woman transmitting COVID-19 to the fetus
appears to be very low. But once the baby is born, person-to-person
spread is possible.
Symptoms
Most people with COVID-19 have mild or no symptoms, but some
become severely ill and die. Symptoms can include fever, cough, and
shortness of breath. Occasionally, loss of smell or taste can be the
first symptom.
Whether pregnancy increases the risk of getting COVID-19 and/or
its causing severe symptoms is unknown. But the available information
suggests that the risk seems to be the same as that for other adults.
The risk of problems during pregnancy (such as preterm labor, birth of a premature newborn, and preeclampsia) may be increased if symptoms are moderate or severe. More information is needed to confirm that risk the is increased.
Diagnosis
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A doctor's evaluation
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Tests to identify the virus
Diagnosis of COVID-19 in pregnant women is similar to diagnosis
in people who are not pregnant. COVID-19 is suspected if people have a
fever, a cough, sudden loss of smell or taste, and/or trouble breathing
and they could have been exposed to the virus.
To confirm the diagnosis, doctors may take samples of fluids from
the respiratory tract to be tested. Polymerase chain reaction (PCR)
techniques can help doctors identify the virus. This tests can be used
to make many copies of the virus's genetic material and thus make
identification easier. If a test is not readily available or if symptoms
are mild, the diagnosis may be based on symptoms and likelihood of
exposure (if it can be determined).
If needed, chest x-ray and/or computed tomography (CT) is done.
Prevention
The best way to prevent COVID-19 is to avoid being exposed to the
virus, which can be difficult because some infected people do not know
they have the virus. The Centers for Disease Control and Prevention (CDC) has issued recommendations for preventing the spread of COVID-19. These recommendations apply to all people (see also Prevention of COVID-19).
In addition, pregnant women should call their health care
practitioner to determine whether they can have fewer prenatal visits
and visits for testing (such as for blood or urine tests or
ultrasonography). Reducing the number of visits can reduce the risk of
exposure to COVID-19. For example, instead of a visit, women can talk
with their health care practitioner on the telephone or have an online
video call (telemedicine).
If fetal monitoring is needed, practitioners can sometimes do it
in a way that requires less contact between health care practitioners
and the woman. For example, they can monitor the fetus from outside the
examination room electronically or with Bluetooth, although they must
enter the room to attach the monitor.
If a pregnant woman may be infected, separating her from her baby
after delivery may be necessary until doctors determine whether the
baby is infected.
Breastfeeding
The risk of a mother transmitting the virus through breast milk
is low or nonexistent. But more information is needed to determine
whether an infected mother can pass the virus to the baby in breast
milk. If a mother wants to breastfeed her baby, she should do the
following unless the health care practitioner has determined that she is
not infected:
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Wash her hands before preparing to breastfeed and before touching any breast pump or bottle parts.
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Express milk to be taken and fed to the infant by a caregiver who is not infected.
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Clean all pump and bottle parts after use.
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If she chooses to breastfeed directly, wear a face mask and wash her hands before each feeding.
Treatment
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Acetaminophen to relieve fever and muscle aches
Treatment of COVID-19 in pregnant women and people who are not pregnant is similar.
Acetaminophen may be used to relieve fever and pain, such as muscle aches.
Before delivery, pregnant women with COVID-19 should notify the
hospital that they have the infection. Then the hospital staff can take
the needed precautions to prevent spread of the virus.
More Information
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American College of Obstetricians and Gynecologists: Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients
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Centers for Disease Control and Prevention (CDC): Coronavirus (COVID-19)
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