Are pregnant women more susceptible to COVID-19 or at higher risk for complications of COVID-19?

Pregnancy and childbirth generally do not increase the risk for acquiring severe acute respiratory syndrome Corona Virus 2 (SARS-CoV-2) infection, but appear to worsen the clinical course of COVID-19 compared with non- pregnant individuals of the same sex and age; however, most (>90 percent) infected persons recover without undergoing delivery.

Does COVID-19 increase the risk for pregnancy complications?

Yes, infected women, especially those who develop pneumonia, appear to have an increased frequency of preterm birth (birth before 37 weeks of gestation) and possibly cesarean delivery, which is likely related to severe maternal illness. Most preterm births are iatrogenic (i.e., induced labor or scheduled cesarean delivery).

How can prenatal care be modified to decrease risk of contracting COVID-19?

Modifications should be tailored for low- versus high-risk pregnancies (e.g., multiple gestation, hypertension, diabetes) and may include telehealth in areas of active infection transmission, reducing the number of in-person visits, timing of visits, grouping tests (e.g., aneuploidy, diabetes, infection screening) to minimize maternal contact with others, restricting visitors during visits and tests, timing of indicated obstetric ultrasound examinations, and timing and frequency of use of non- stress tests and biophysical profiles.

Are SARS-CoV-2 vaccines safe for pregnant women and women planning pregnancy?

Yes. We recommend COVID-19 vaccination for pregnant women rather than deferring vaccination until after delivery. This recommendation is based on increasingly reassuring data regarding the safety and efficacy of COVID-19 vaccines during pregnancy as well as data that pregnancy itself is associated with an increased risk of severe infection (CDC tier 1c vaccine allocation). The SARS-CoV-2 vaccines that are clinically available do not contain virus that replicates.

Vaccination can occur at the same time as administration of a routinely administered vaccine, such as the Tdap and influenza; a separation period is unnecessary.

Vaccination is not thought to affect fertility, and it is not necessary to delay pregnancy after vaccination.

Is maternal COVID-19 an indication for cesarean delivery?

No, COVID-19 is not an indication to alter the route of delivery. Even if vertical transmission is confirmed as additional data are reported, this would not be an indication for cesarean delivery since it would increase maternal risk and would be unlikely to improve newborn outcome.

Should planned induction of labor or cesarean delivery of asymptomatic women be postponed during the pandemic?

No, in asymptomatic women, inductions of labor and cesarean deliveries with appropriate medical indications should not be postponed or rescheduled. This includes 39-week inductions or cesarean deliveries after patient counseling.

Can an asymptomatic partner/support person attend labor and delivery?

Practices vary by institution. At a minimum, the support person should be screened in accordance with hospital policies, and those with any symptoms consistent with COVID-19, exposure to a confirmed case within 14 days, or a positive test for COVID-19 within 14 days should not be allowed to attend the labor and birth. Most facilities recognize that a support person is important to many laboring women and permit one support person who must remain with the laboring woman (may not leave the room and then return). Additional support persons may be allowed or can be a part of the patient's labor and delivery via video.

How should the baby be evaluated?

If the mother has known COVID-19, the infant is a COVID-19 suspect and should be tested, isolated from other healthy infants, and cared for according to infection control precautions for patients with confirmed or suspected COVID-19.

Should mothers with COVID-19 be separated from their baby?

Generally no because the newborn's risk for acquiring SARS-CoV-2 from the mother is low, and data suggest no difference in risk of neonatal SARS-CoV-2 infection whether the neonate is cared for in a separate room or remains in the mother's room. However, mothers should wear a mask and practice hand hygiene during contact with their infants. At other times, physical distancing >6 feet between the mother and neonate or placing the neonate in an incubator is desirable when feasible.

How long should mother-baby precautions at home continue after recent infection?

Previously symptomatic mothers with suspected or confirmed COVID-19 are not considered a potential risk of virus transmission to their neonates if they have met the criteria for discontinuing isolation and precautions:

• At least 10 days have passed since their symptoms first appeared (up to 20 days if they have more severe to critical illness or are severely immune compromised).
• At least 24 hours have passed since their last fever without the use of antipyretics.
• Their other symptoms have improved.
• For asymptomatic mothers identified only by obstetric screening tests, at least 10 days should have passed since the positive test.

Can breast milk transmit SARS-CoV-2?

There is general consensus that breastfeeding should be encouraged because of its many maternal and infant benefits. It is unknown whether SARS-CoV-2 can be transmitted through breast milk because very few breast milk samples have been tested. In a World Health Organization (WHO) study, breast milk samples from 43 mothers were negative for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) and samples from three mothers tested positive, but specific testing for viable and infective virus was not performed.

What precautions should mothers with confirmed or suspected COVID-19 take when breastfeeding?

Droplet transmission from infected mothers to their baby could occur through close contact during breastfeeding. Mothers can take precautions to prevent this by performing hand and breast hygiene and using a face mask.

Alternatively, the infant can be fed expressed breast milk by a healthy caregiver following hygiene precautions until the mother has recovered or is proven uninfected. In such cases, the mother should use strict hand washing before pumping and wear a face mask during pumping.

How do prescription and over-the counter medications affect my pregnancy?

Basically, any medications, vitamins, minerals, and supplements you ingest during pregnancy even a simple paracetamol or cold medicine -should be brought up with your ob-gyn. There are some s which cross the placenta barrier and may be harmful for baby and only your gynaec knows it the best.

Is there anything off-limits in the sex department?

Unless you have"< placenta previa or"< preterm labor, pretty much anything that both you and your partner are okay with and which doesn't cause pain or discomfort-is fine. However, it's important to practice proper oral hygiene. "Use good, common sense is what 'Wallaby' advises.

Talk to us or your ob-gyn openly about your sex life to see if there's anything she thinks you should abstain from.

Is it okay to exercise?

At one time, women were told to take it easy during pregnancy, and this extended to exercise. However, not only are pregnant women encouraged to keep active today, there are many benefits to exercise including a reduction in backaches, constipation, bloating, and stress.
Still talk to your doctor about what's right for you.
"You should avoid overheating during pregnancy and not go over a pulse of 140," ""‹Some exercises should be avoided as pregnancy progresses, since your center of gravity changes, plus your joints may be looser."
Workouts like swimming and walking are particularly good, while downhill skiing, contact sports (like basketball, soccer, and hockey), and scuba diving should be avoided.

How does stress affect my pregnancy?

Let's face it: We all have stress in our lives, and pregnant women are hardly exempt. "The "‹stress question is the hardest question asked today.
Occasional mild-to moderate stress probably does not affect the pregnancy, but big issues affect every part of your life." Have a candid conversation with your Pregnancy counselor and tell her about some of the big stressors in your life (problems with your spouse, a big move, or job issues). She may be able to recommend something good for you.

Do I have to cut out coffee?

The coffee question comes up a lot, with "‹people taking different viewpoints.
"Limited amounts of caffeine, up to 200 milligrams daily, are safe in pregnancy." However, she cautions that many women are-

• Hypersensitive to coffee
• And some other foods Including soda, tea, and chocolate.
• Read labels, and make sure you're not getting more than your daily allotment.
• Also, talk to your ob-gyn on what she feels is a good amount.

When should I call the doctor?

For many pregnant women, the big question is what's normal, and what's not.
WALLABY is all ears to your problems, big or small.
"Any "‹bleeding during pregnancy, particularly if it's associated with cramps, warrants a phone call. Most of the time it is harmless, but your provider can help determine if there's a Problem. Any if the symptoms like unusual pain or pain that won't go away, leakage of water or other discharge from your vagina-should be followed up with a doctor's visit. But the fact of the matter is, if you're ever worried about a pregnancy symptom you're experiencing, you should feel comfortable giving your ob-gyn a call.

How does my weight affect my pregnancy?

Ideally, you're at a healthy weight before you even get pregnant.
Once you're expecting, you want to "‹keep within a certain range. "A major concerning trend that I'm seeing is that many women are overweight going into the pregnancy, which puts them at a higher risk for gestational diabetes.