Sidra Medicine offers advice for pregnant women about COVID-19

18 March 2020, Doha, Qatar – The Women’s Services team at Sidra Medicine, a member of Qatar Foundation advice pregnant women and addresses some common questions about COVID-19.

“There is currently limited information about the effects of COVID-19 on pregnant women. However, since pregnant women experience changes in their bodies, this may increase their risk of some infections and getting sicker, compared to the general population. Premature births have been reported among infants born to mothers that caught the COVID-19 virus during pregnancy, however, it is not clear that these outcomes were related to maternal infection. As with the current advice related to COVID-19, we recommend pregnant women follow the guidelines from Qatar’s Ministry of Public Health (MOPH) and keep in regular contact with their healthcare provider,” said the Women’s Services team at Sidra Medicine.

To reduce the risk of catching COVID-19, please follow these general instructions:

  • Wash your hands with soap and water - often and very well - for at least 20 seconds. This should be done as soon as you come back home or you are heading into work from a public place.
  • Use hand sanitizer, if soap and water are not available.
    • Cover your mouth and nose with a tissue or the inner part of your elbow or your sleeve (not your hands) when you cough or sneeze.
    • Throw used tissues in the bin straight away and wash your hands afterwards.
    • Avoid close contact with people who are unwell.
    • Avoid touching your eyes, nose or mouth.
    • Clean surfaces before touching anything including your phone. Viruses can last a few hours to a few days on surfaces.
    • Use a clean tissue to open doors and wash your hands or use hand sanitizer
    • Keep a safe space between you and others in public and avoid contact like shaking hands or hugs when greeting people.
    • Practice social distancing and stay at home and avoid going to public places unless it is absolutely necessary. Do not go out during rush or peak hours.

Common questions if you are pregnant and have been diagnosed with COVID-19:

  1. What should I do if I think I may have COVID-19 or if I have been exposed?

Call Qatar’s Ministry of Public Health (MOPH) hotline 16000, if you are pregnant and you have the following conditions:

  • Fever and / or symptoms of a respiratory illness (e.g. cough, runny nose or shortness of breath.
  • You have been to a country or area infected with COVID-19 in the last 14 days.
  • You have been in close contact with someone with suspected or confirmed COVID-19.
  1. What should I do if I have been diagnosed with COVID-19?

You will be treated in a COVID -19 site hospital arranged by Qatar’s Ministry of Public Health. Please note that Sidra Medicine is not a COVID-19 hospital site and will not admit suspected or COVID-19 positive patients.

  1. What should I do if I am advised to self-isolate?

Pregnant women who have been advised to self-isolate should stay indoors and avoid contact with others for 14 days. This means:

  • Choose a separate room, preferably with a separate ensuite bathroom, and ventilate it regularly
  • Do not go to school, work, shopping or public areas
  • Do not use public transport
  • Stay at home and do not allow visitors
  • Avoid sharing household items. You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with other people in your home. After using these items, you should wash them thoroughly with soap and warm water
  • Use friends, family or delivery services to do tasks on your behalf, but advise them to leave items outside your door
  • For more information on home-isolation, visit Qatar’s MOPH website which has a selection of educational materials that you will find useful.
  1. Can I still attend my antenatal appointments if I am in self-isolation?
  • Contact your antenatal clinic to inform them that you are currently in self-isolation for suspected or confirmed COVID-19. Your healthcare provider may advise you to :
    • Delay your appointment until your isolation ends.
    • Come for you appointment if it is urgent and the necessary arrangements will be made for you to be seen. For example, you may be asked to attend at a different time, or in a different clinic, to protect other patients.
  • If you have been diagnosed with COVID-19, you will be followed up in a specialized COVID-19 hospital as determined by Qatar’s MOPH.
  1. How will my care be managed after I have recovered from COVID-19?

As a precautionary approach, you will be asked to do an ultrasound 14 days after your recovery, to check that your baby is well. If you have recovered from COVID-19 and tested negative for the virus, your previous illness will not affect how and where you give birth unless instructed otherwise.

  1. If I am diagnosed with COVID-19, how would this affect my baby?

It is still unknown at this time if COVID-19 would cause problems during pregnancy or affect the health of the baby after birth. Early/ Premature births have been reported among infants born to mothers that caught the COVID-19 virus during pregnancy however, it is not clear that these outcomes were related to pregnancy infection.

  1. What do I do if I feel unwell, worried about my baby or experience labor pains during self-isolation?

If you have any of the above concerns during your self-isolation period, call Qatar’s MOPH Hotline 16000 and you may be advised to go to a MOPH designated site for pregnancy related care.

Pregnant women on self-isolation or those who have been exposed and have COVID-19 symptoms are advised not to visit Obstetrics triage or an Outpatient Clinic unless in need of urgent medical care.

If you are a Sidra Medicine patient and would like to speak to one of our obstetricians, please call 40031419 for further advice.

  1. What do I need to know if I have the COVID-19 infection and I am in labor?
  • You will be assigned to a designated COVID-19 hospital by Qatar’s MOPH. Follow the recommendations given to you by the medical team of that hospital.
  • You will be required to travel by private transport or call an ambulance
  • Prior to entering the hospital, inform the triage security staff about your condition.
  • Your medical team will meet you at the maternity unit entrance and provide you with a surgical face mask to wear until you are isolated in a suitable room.
  • Your birth partner might be able to stay with you throughout your labor (this depends on the hospital’s policy)
  • Make sure you have minimum companions. To ensure your safety your medical team will decide the number of companions
  • Ask any visitors to stay home.
  1. If I have the COVID-19 infection, will it affect how I give birth?

There is currently no evidence to suggest that COVID-19 may affect how you may give birth. Your original birth plan should be followed as closely as possible and based on your wishes. However, if you have severe breathing difficulty indicating urgent delivery, then a cesarean birth may be recommended.

There is no evidence that women with suspected or confirmed COVID-19 cannot have an epidural or a spinal block. However, the use of gas and air (Entonox =Nitrous Oxide) may increase the spread of the virus via aerosolization and is not recommended. Therefore other options may be discussed.

  1. Will my baby be tested for COVID-19?

Yes, if you have suspected or confirmed COVID-19 at the time your baby is born, your baby will be tested for COVID-19.

  1. Will I be able to stay with my baby/give skin-to-skin if I have suspected or confirmed COVID-19?

If you are confirmed to have COVID-19, you will be at an MOPH designated hospital site and will be asked to follow the recommendations of their medical team.

Based on the severity of the medical condition of the baby and/or the mother, separation will be advised by the medical team in a case by case basis.

  1. Will I be able to breastfeed my baby?

At the moment there is no evidence that the virus can be carried in breastmilk, it is recommended that you continue to breastfeed and follow your medical team’s advice based on the situation.

The main risk of breastfeeding is close contact between you and your baby leading to infection of the baby after birth. When breastfeeding, the following precautions are recommended:

  • Wear a face mask if you choose to breastfeed
  • Wash your hands with water and soap before touching your baby, breast pump or bottles
  • If you are expressing breast milk in the hospital, you must be very careful to clean the equipment and sanitize your breasts and your hands before pumping.

Read the Arabic here.

Disclaimer: Information related to COVID-19 is constantly evolving with several updates and recommendations daily. Sidra Medicine recommends following credible sources of information including Qatar’s Ministry of Public Health (MOPH); the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), Atlanta USA.

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References

  1. Practice Advisory: Novel Coronavirus 2019 (COVID-19); American college of obstetricians and gynecologists; 9th March, 2020
  2. COVID-19 Virus Infection and Pregnancy, Information for pregnant women and their families; Royal College of Obstetricians and Gynecologists, 9th March, 2020
  3. Ministry of Public health, Qatar; https://www.moph.gov.qa/english/Pages/Educational-Materials.aspx
  4. World Health Organization Covid-19 advice for Public ; https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public