The World Health Organization and the U.S. Centers for Disease Control and Prevention advise pregnant women—and those around them—to take precautions to protect themselves against COVID-19. This is because they (including those who were recently pregnant) are at an increased risk for severe illness from COVID-19 when compared to people who are not pregnant.
We spoke with OB-GYN Dr. Arlene Alonte-Ancheta to get answers on common questions expecting mamas have during this pandemic.
What specific measures should pregnant women do to avoid catching the COVID-19 virus?
It’s important for you to be proactive because when you are pregnant, there are a lot of changes in your body and in your immune system that make you become immunocompromised and more vulnerable to any disease like COVID-19. Do everything you can, including physical distancing, wearing a mask, hand washing, and staying in close communication with your doctor. Prenatal checkups can be done by teleconsultation if there's a surge in cases.
If a pregnant woman contracts the virus, what specific steps should they do?
Isolate. Observe for symptoms (fever, cough, sore throat, difficulty of breathing, etc.). Check oxygen saturation through a pulse oximeter and monitor fetal movements if they are normal. Continue your multivitamins, ferrous sulfate and calcium supplements, but usually I add Vitamin C with zinc. I also recommend for more water intake, eating healthy food, and lots of rest. After the isolation, I ask them to come visit so we can check the status of both the mother and the baby through an ultrasound and repeat laboratory tests.
Which is the most dangerous trimester to contract COVID-19?
The effects of COVID-19 is mostly dangerous in the second and third trimesters. Preterm delivery, preterm prelabor rupture of membranes (PPROM), and intrauterine fetal distress are potential complications of maternal COVID-19 infection, possibly caused by maternal hypoxemia. In the first trimester, limited data is available on pregnancy outcomes in COVID-19 infection cases.
When should COVID-positive pregnant women do home care or when should they be in a healthcare facility?
Not all pregnant patients infected with COVID-19 warrants admission. Those who are asymptomatic or with mild disease (cough, colds, headache, body malaise) with no comorbidity disease can do home care or isolation with proper instructions and counseling from their doctors. Only those with severe disease or symptoms and are critically ill should be admitted in the hospital.
What if the patient is still COVID-positive at the time of giving birth?
Care should be provided in a hospital that can monitor maternal and fetal monitoring during admission with COVID-19 patients, but in general, the therapeutic management of pregnant patients with COVID-19 should be the same as for non-pregnant patients. The mode of delivery should be individualized based on obstetrics indications. COVID-19 infection is not an indication to change the mode of delivery—vaginal deliveries can be attempted and Cesarean section is performed if indicated.
COVID-19 pregnant patients with severe disease needs to have a multi-disciplinary team approach composed of an obstetrician, intensivist, pulmonologist, infectious disease specialist, and obstetric anesthetist because it’s more complicated.
Important: Expecting moms are also advised to take the COVID-19 vaccine. Here are some reminders on what to do before, during, and after your vaccine appointment.
(Dr. Arlene Alonte-Ancheta is an OB-GYN who has clinics at the Asian Hospital Medical Center and at Cornerstone Ambulatory Clinic.)
