COVID-19 During Pregnancy

Diagnosis of COVID-19 is similar in pregnant and nonpregnant patients.

Chest x-ray and/or CT, if otherwise indicated, should be done because the fetal radiation doses are low.

The Society for Fetal-Maternal Medicine (SMFM) and the American College of Gynecology (ACOG]) have a suggested algorithm for triage and evaluation of pregnant women with possible COVID-19 (1 Diagnosis reference COVID-19 (coronavirus disease 2019) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Information about COVID-19 and interim care guidelines are evolving rapidly... read more ). Recommendations in this algorithm are similar to those for evaluation of nonpregnant patients.

General medical treatment for COVID-19 Treatment COVID-19 is an acute, sometimes severe, respiratory illness caused by the novel coronavirus SARS-CoV-2. Prevention is by vaccination and infection control precautions (eg, face masks, handwashing... read more is mainly supportive and is similar in pregnant and nonpregnant patients. Acetaminophen is recommended for treatment of fever and mild to moderate pain.

Oxygen saturation should probably be kept > 95% or a PaO2 of > 70 mm Hg.

All pregnant women should be advised to follow the CDC guidelines for preventing COVID-19 and to take precautions to minimize their exposure, including staying at home as much as possible, regular handwashing, and social distancing. These precautions are similar to those in nonpregnant patients.

All health care workers should wear appropriate personal protective equipment (PPE).

To decrease exposure to pregnant women, health care practitioners should contact their pregnant patients about consolidating prenatal visits and ultrasound appointments, although consensus about how to schedule such appointments has not yet been determined. Blood pressure, blood glucose, and fetal monitoring tracings can sometimes be transmitted electronically, and some appointments may be done through telephone or video conferencing.

Separating mother and infant after delivery should be considered on a case-by-case basis. Ending separation may need to wait until risk of transmission to the infant has been thoroughly evaluated. Evaluation should usually include laboratory testing.

Risk of transmitting the virus in breast milk is low or absent. If the woman chooses to breastfeed continually despite being separated from her infant, she should express milk to be transported and fed to the infant by a caregiver who is not infected unless COVID-19 has been ruled out in her. When expressing breast milk, a woman should be advised to practice good hand hygiene (eg, washing her hands before touching the breast pump and bottle parts and before expressing breast milk). A dedicated breast pump should be used if possible; it and all pump parts that contact the breast or breast milk should be thoroughly cleaned and disinfected after use. The pumping area (eg, dials, power switch, counter top) should be cleaned with disinfectant wipes. If the woman chooses to breastfeed directly, she should wear a face mask and wash her hands before each feeding.