Coronavirus unknowns cause concern in pregnant women and newborns

Coronavirus unknowns cause concern in pregnant women and newborns

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At first, the doctors said that the coronavirus was not a risk to Pregnant women or the very young. But now – as the pandemic escalates and experts scramble to sketch a deeper understanding – some warn that there are more unknowns than known ones.

“Having a problem-free delivery in the midst of a pandemic added anxiety to an already stressful situation,” Dr. Edith Bracho-Sanchez, assistant professor of pediatrics at Columbia University Irving Medical Center in New York, told Fox News. “Our hospitals have worked very hard to screen mothers, babies and visitors to detect symptoms, test if necessary and closely monitor those who test or test positive.”

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The images and anecdotes from around the world in recent weeks – depicting a first foray into outdoor life – are a creaky reflection of our new world that gives food for thought about dealing with the most serious health crisis of more than a century.

A newborn baby girl in Bangkok, Thailand, was wrapped in coveralls and a large transparent protective face shield. Parents from all over the United States and Europe are forced to do just FaceTime with their tiny, premature arrivals – unable to be physically by their side as they cocoon in neonatal intensive care units.

And collective grief rocked much of the United States on Monday after it was revealed that an expectant mother from Louisiana, who was hospitalized with a coronavirus, went premature work at 22 weeks. Her child, not even a day old, did not succeed. Although the incident remains under investigation and the baby has not been tested positive, it is classified as coronavirus-related death because it was claimed that the early delivery was caused by the contagion.

Previous studies of related respiratory diseases, called SARS and MERS, have also indicated that contagion can cause miscarriage or early labor.

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In addition, at least two women in New York, according to Columbia University Medical Center, who had the virus – officially called COVID-19 – quickly deteriorated in the hours after giving birth. While their babies were not infected, moms spent their first precious bonding moments fighting for their lives in the intensive care unit.

Photo: Newborn girl delivered by caesarean section at a designated coronavirus treatment center, Harbin Sixth People’s Hospital; It is the healthy little girl born in quarantine of a mother carrying the deadly Wuhan coronavirus and delivered by doctors dressed in dangerous suits who were themselves isolated as a precaution.

Given the novelty of the disease, which was barely heard of just a few months ago, much of the information released by scientists and medical experts quickly becomes obsolete as new information, models and anomalies emerge. . Almost nothing about the disease can be considered conclusive. Data are at best preliminary, and there are no data for women infected with a coronavirus during their first trimester.

“So far, we believe the virus is not passed from mom to baby during pregnancy, and although there have been some reports that it could be, the data is inconclusive,” noted Bracho-Sanchez. “But it is important to mention that we are very early in the understanding of this virus, and pregnant women still need to take precautions. To be clear, in the vast majority of cases, the data shows that mothers with COVID-19 deliver healthy babies at term or a week or two before term. “

Nevertheless, caution is advised to all expecting mothers, regardless of the stage of pregnancy – not only given the little known knowledge, but since pregnancy weakens the immune system and makes them more vulnerable to disease.

And the ripple effects for pregnant women, following the global health disaster, are increasing in more ways than one.

“People, in general, think twice about scheduling medical appointments and being in contact with hospitals or clinics because they are afraid of being infected with the new coronavirus. On the other hand, pregnant women must still receive regular antenatal care and must be in contact with their OBs during this time, “said Dr. Karin Nielsen-Saines, professor of clinical pediatrics at the David Geffen School of Medicine from UCLA, Division of Infectious Diseases, Department of Pediatrics and member of the American Pediatric Society (APS). “Some hospital settings are implementing screening tests for all patients admitted for this virus, including pregnant women admitted to childbirth in order to reduce potential exposures to staff and vulnerable newborns. It is a time when everything changes and guidelines change constantly. “

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The devastating pandemic has also left hospitals and clinics across the country struggling to change policies to protect the spread and limit who is allowed to enter a hospital. Last month in New York, the world’s epicenter of the coronavirus attack, hospitals banned others from being in a delivery room while a mother gave birth. However, after an outcry, the authorities have overturned the decision and are currently authorizing a support person to work alongside him.

In some hospitals, due to the influx of patients and being at full capacity, partners are limited to being there for childbirth or around the services if the patient is before or after childbirth, “explained Dr. Hansa Bhargava, WebMD’s senior medical director. “It is difficult for expectant mothers, especially at a difficult time – labor and delivery.”

This undated photo, courtesy of the British Health Protection Agency, shows the coronavirus seen under an electron microscope. Saudi Arabia will not issue visas to the elderly, pregnant women or children for Hajj and Umrah pilgrimages to combat the spread of the MERS coronavirus, the French Ministry of Health said on Tuesday.

This undated photo, courtesy of the British Health Protection Agency, shows the coronavirus seen under an electron microscope. Saudi Arabia will not issue visas to the elderly, pregnant women or children for Hajj and Umrah pilgrimages to combat the spread of the MERS coronavirus, the French Ministry of Health said on Tuesday.
(AFP / File)

But there are some concerns, especially in coronavirus hotspots such as New York and New Jersey, regarding bed shortages and ensuring adequate isolation of potentially infected people.

“The hospitals are doing their best to manage the resources. Some shortages of health workers have occurred because in the event of illness or symptoms, they are asked to stay at home, ”said Bhargava. “It means a smaller pool of nurses for some hospitals, which can be difficult. But for the most part, hospitals are doing well. “

According to a new study released Monday by the Centers for Disease Control and Prevention (CDC) – the largest ever regarding the threat of coronavirus in children – of the 2,500 cases of childhood coronavirus analyzed in the United States; infants were more likely to be hospitalized than their older counterparts due to an alleged lack of developed immunity. Infants had a significantly higher hospitalization rate than any other age group of children. Of 95 infants, 62% were hospitalized. The estimated rate for children aged 1 to 17 was approximately 14%.

And contrary to perceptions of the early days of the epidemic, some children develop severe symptoms. In the new CDC study, 147 of the patients were hospitalized, five of whom were sent to intensive care. Three children died.

The results are consistent with those released earlier this year in Wuhan, China – where the virus originated – who examined 2,100 pediatric patients and concluded that more than 90% of childhood coronavirus infections were considered asymptomatic, but that infants were more sensitive.

In early February, a Chinese newborn baby tested positive for coronavirus only 30 hours after birth, which marked the youngest known case. State media reported that the mother had a positive result before delivery, but it was unclear whether the infant had contracted the disease in the womb or during / after labor.

“The main concern is that newborn babies can become infected soon after birth and become very sick. However, most studies to date suggest that infants who contract the virus do not tend to get very sick and have mild to no respiratory symptoms, “said Nielsen-Saines. “However, some infants had a low-grade fever and could have chest radiological abnormalities. It has also been shown in some of these studies that babies can get rid of the virus in their stools for a few weeks after infection. “

Connecticut health officials announced Sunday that a newborn at Windsor Locks had tested positive for the pathogen, but has not released any other information indicating whether the mother or anyone else in close contact has been confirmed as having the virus. The infectious and pediatric experts at John Hopkins Medical Center also said that while the coronavirus can be contracted by very young people, it tends to be much milder in babies and children.

With regard to pregnant mothers who fall ill, Ann Yates – the chief midwife counselor of the International Confederation of Midwives (ICM) in the Netherlands – pointed out that, as things stand the vast majority of pregnant women will only suffer from a mild or moderate cold / flu-like symptoms.

“Cough, fever and shortness of breath are other relevant symptoms. There is currently no evidence that the virus causes increased miscarriages, premature births or stillbirths, “she said. “Women who are not feeling well may need additional care from their health unit so that they can monitor both the mother and the baby.”

Since there is no approved vaccine or cure for the coronavirus, healthcare professionals recommend that parents take all possible precautions to prevent transmission.

Despite initial assumptions that a mother could not transmit the coronavirus through breastfeeding, and the CDC advising that moms with coronavirus could still breastfeed provided she washed her hands and wore a mask, new set recommendations published this week at the American Academy of Pediatrics recommend the “temporary separation” of a diagnosed mother and ask for the pumping of breast milk until the infection disappears. The CDC has not yet ordered moms to separate but has called them to “consider” the option.

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And as much of the mystery swelling around this all-new disease, it remains to be seen what long-term changes this will bring to the world of pre and postnatal care.

“It will depend on the duration of this pandemic. For the most part, if this virus behaves like other seasonal respiratory viruses, this situation we face should last for a few more months, then we should return to normal childbirth practices, ”added Nielsen-Saines. “As we live in what we all recognize as an unprecedented era, many medical and social practices have changed to protect us during this time. Most of these practices implemented during this state of emergency should not necessarily be permanent. “

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