The coronavirus infection, which causes serious health problems in all countries of the world, was first seen in 2019, and it was named as Coronavirus Disease 2019 (Covid19). was also a cause for concern. Considering the current data we have, Covid19 infection during pregnancy does not show a significant difference with the normal population in terms of clinical course. In symptomatic cases, the severity of symptoms in pregnant women is similar to that of non-pregnant women. 86% of the pregnant women had mild disease, 9.3% had severe disease and 4.7% had critical illness. 80% of the normal non-pregnant Covid 19 positive population survived the disease as mild, 15% severe and 5% critical. Severe symptoms requiring intensive care such as acute respiratory syndrome, renal failure, and multiple organ failure may also be seen. Pregnant women with risk factors for severe disease; Pregnancy over 35 years of age, obesity, hypertension, diabetes, severe respiratory disease such as advanced asthma, chronic liver or kidney disease, and those using immunosuppressive drugs can be counted.
Pregnant women should follow the same recommendations as non-pregnant individuals to avoid exposure to Covid19 infection. They should wash their hands with soap and water for at least 20 seconds, should not touch their mouth, nose and eyes, use disposable napkins when sneezing, should not leave the house unless it is necessary, wear a mask when leaving the house and stay away from crowded environments. Within the framework of social distance rules, other people should not be approached more than 2 meters, shake hands or hug. After touching objects that many people have touched, such as money, elevator buttons, doorbells, hands should be washed with soap and water. Personal items such as cell phones, towels and glasses should not be shared with others. During this process, one should not be in closed and unventilated environments, no guests should be accepted into the house, attention should be paid to sleep patterns, and a healthy and balanced diet should be given. At least 2 liters of water should be drunk throughout the day, should not travel to high-risk areas and should not take public transportation unless necessary. Vaccination to protect against Covid 19 infection is not recommended for our pregnant women.
How often should pregnancy follow-ups be done?
Due to the increased risk of contagion, especially in crowded environments such as hospitals, with the Covid19 Pandemic, we may recommend that pregnant women reduce their routine follow-up. This situation can be applied in normal pregnancies, but we may experience problems with maternal and infant health in high-risk pregnancies. For a healthy pregnancy follow-up, confirmation of pregnancy with ultrasonography in the first 12-week period, routine tests and first trimester screening test, and second-level ultrasonography scanning at 22 weeks of gestation can be considered sufficient. After that, the frequency of follow-up may be every six weeks until the 34th week, and then every 3-4 weeks depending on the patient's condition. However, it is important for the expectant mother to follow the baby's movements very closely during this period, to monitor her own weight changes and the growth of her abdomen, and to contact the physician in case of emergency.
What are the symptoms and treatment of Covid 19 infection during pregnancy?
Despite all the precautions taken, if the expectant mother is infected with coronavirus, follow-up and treatment is planned according to the symptoms and the severity of the symptoms. Asymptomatic Covid 19 pregnant women need self-isolation by protecting their family members at home during the illness. In cases with mild symptoms, fluid and electrolyte balance is achieved and treatment is applied according to the symptoms. Antiviral therapy is not recommended in mild cases based on current data. In mothers with severe Covid19 symptoms, they are hospitalized and treated by a multidisciplinary team.
What are the pregnancy and newborn outcomes in those who had Covid 19 infection during pregnancy?
No significant difference was found in the rates of congenital anomaly, miscarriage and stillbirth in pregnant women who had Covid 19 infection. However, it is observed that the frequency of preterm labor and cesarean delivery increases in pregnant women who have had pneumonia.
To date, no virus has been detected in the blood or nasal swabs and placenta of newborns born to pregnant women with Covid 19 infection. It is recommended that mothers who have mild infection breastfeed their babies with a mask.
