New Corona Virus (COVID-19) Management in Pregnancy and Childbirth

Abstract

Context: Coronavirus disease 2019 (COVID-19) is an emerging disease that has been associated with a rapid increase in afflicted cases and deaths since its first introduction in Wuhan, China, in December 2019. The emerging infection can have a significant impact on pregnant women and the fetus. The purpose of this study was to review and summarize the latest research on the management and treatment of women in pregnancy and childbirth in the world and management protocols available in Iran and other countries. Evidence Acquisition: In this review study, we examined Persian and English studies by searching the Pubmed, Web of Science, UpToDate, SID, Scopus, Google Scholar, and medRxiv databases with keywords pregnant, pregnancy, gravidity, coronavirus, infection, COVID-19, and their Persian equivalents. Articles and reviews were on humans. After reviewing and removing duplicate and non-eligible articles, 12 articles and 11 guidelines and recommendations were obtained. Results: The results of the review study were categorized as follows: clinical course of COVID-19 in pregnancy, perinatal outcomes, neonatal outcomes, vertical transmission potential, management of COVID-19 in pregnancy, labor, and delivery in women, postpartum stage in women with COVID-19, breastfeeding, and care for a infant born to a mother with COVID-19. The general principles of caring for women in pregnancy and childbirth included early separation, using aggressive infection control methods, non-administration of corticosteroids repeatedly, oxygen therapy, preventing from fluid overload, using empirical antibiotics (due to the risk of secondary bacterial infection), co-infection testing of other infections, avoiding breastfeeding in mothers with definitive positive tests, and being cautious in suspicious cases. Conclusions: Given the limited information on the complications and outcomes of the virus in pregnancy and childbirth and the increasing number of studies, the provision of up-to-date care according to global and regional processes and guidelines is recommended for mothers affected and suspected with COVID-19.