Wikipedia:WikiProject COVID-19/Translation Task Force/COVID-19 in pregnancy (long)

The effect of COVID-19 infection on pregnancy is not completely known because of the lack of reliable data. Predictions based on similar infections such as SARS and MERS suggest that pregnant women are at an increased risk of severe infection but findings from studies as of March 2020 show that clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported from non-pregnant adults. There are no data suggesting an increased risk of miscarriage of pregnancy loss due to COVID-19 and studies with SARS and MERS do not demonstrate a relationship between infection and miscarriage or second trimester loss.

It is unclear yet whether conditions arising during pregnancy including diabetes, cardiac failure, hypercoagulability or hypertension might represent additional risk factors for pregnant people as they do for non-pregnant people. From the limited data available, vertical transmission during the third trimester probably does not occur, or only occurs very rarely. As of April 2020, there is no data yet on early pregnancy. No data as of April 2020 suggest increased risk of miscarriage or early pregnancy loss in relation to COVID-19.

Recommendations

The World Health Organization and Centers for Disease Control and Prevention of the United States advises pregnant women to do the same things as the general public to avoid infection, such as covering cough, avoid interacting with sick people, cleaning hands with soap and water or hand sanitizersanitizer.

General recommendations

The United Nations Population Fund (UNFPA) recommends seven general measures for all episodes of contact with maternity patients undergoing care:

1. Ensure staff and patient access to clean hand washing facilities prior to facility entry.
2. Have basic soap at each health facility wash station along with a clean cloth or disposable hand towels for hand drying.
3. If midwives provide direct patient care, they must frequently wash their hands with soap and water for at least 20 seconds each time. This must happen before every new woman is seen and again before their physical exam. Midwives should wash again immediately after the exam and again once the patient leaves. Washing should also occur after cleaning surfaces and coughing or sneezing. Hand sanatizer can also be applied especially if clean water is unavailable.
4. Avoid touching the mouth, nose or eyes.
5. Staff and patients should be advised to cough into a tissue or their elbow and wash hands afterwards.
6. Midwives should keep a social distance of at least 2 arms lengths during any clinical visit. As long as hand washing is performed before and after the physical exam women without suspected or confirmed COVID-19, the physical exam and patient contact should continue as usual. if hand washing is performed before and after.
7. Spray surfaces used by patients and staff with bleach or another. Be sure to wipe down the surface with a paper towel or clean cloth in between patients and wash hands.

Antenatal care

The Royal College of Obstetricians and Gynaecologists and Royal College of Midwives advise that antenatal and postnatal care should be regarded as essential, and that "pregnant women will continue to need at least as much support, advice, care and guidance in relation to pregnancy, childbirth and early parenthood as before". To minimise the risk of infection, the RCOG and RCM advise that some appointments may be conducted remotely via teleconferencing or videoconferencing. They recommend that in-person appointments be deferred by 7 days after the start of symptoms of COVID-19 or 14 days if another person in the household has symptoms. Where in-person appointments are required, pregnant patients with symptoms or confirmed COVID-19 who require obstetric care are advised to notify the hospital or clinic before they arrive in order for infection control to be put in place.

During labour

In the UK, official guidelines state that women should be permitted and encouraged to have one asymptomatic birth partner present with them during their labour and birth.

As of April 2020, there is no evidence regarding if there is vaginal shedding of the virus, so the mode of birth (vaginal or caesarean) should be discussed with the person in labour and take into consideration their preferences if there are no other contraindications. If a patient has a scheduled elective caesarean birth or a planned induction of labour, an individual assessment should consider whether it is safe to delay the procedure to minimise the risk of infecting others. Products of conception, such as the placenta, amnion etc. have not been shown to have congenital coronavirus exposure or infection, and do not pose risk of coronavirus infection.

Postnatal care

In the UK, official recommendations state that precautionary separation of a mother and a healthy baby should not be undertaken lightly and that they should be kept together in the postpartum period where neonatal care is not required. According to UN Population Fund, women are encouraged to breastfeed as normal to the extent possible in consultation with the healthcare provider.