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Covid positive pregnant women need not worry, cool head essential to beat the virus: Dr Shahnaz Taing

While the pandemic has been a stressful time for everyone, it has been particularly worrisome for pregnant women or those trying to get pregnant. With new data and studies about Covid-19 and the vaccines to protect against it being released daily, it is

Post by on Friday, May 28, 2021

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 While the pandemic has been a stressful time for everyone, it has been particularly worrisome for pregnant women or those trying to get pregnant. With new data and studies about Covid-19 and the vaccines to protect against it being released daily, it is no wonder that confusion abounds. Rising Kashmir spoke with Dr Shehnaz Taing, Ex Prof. and Head Gynae and Obstetrician, GMC Srinagar to discuss issues related to pregnancy amid the pandemic, and what measures should pregnant women take if they come Covid-19 positive.




What is your advice for Covid-19 positive pregnant women?

If a pregnant woman comes Covid-19 positive, she should not lose heart. She should not become fearful or tense because 98% of patients survive and they do well. Covid-19 is not a death sentence at all. 


There are two terms; one is Quarantine, and another is Isolation. We ask quarantining people who have come in contact with Covid positive people to remain separated from their families for two weeks in a place away from their home. Isolation is different from quarantine. Isolation means the person is Covid-19 positive and such people should remain isolated from their family members. A person who is attending a Covid-19 patient should wear PPE kits, double masks and gloves. This isolation has to continue till patients become Covid negative.


What should be done if a pregnant lady in your home is in isolation?

We do not have to leave her. She must be under the care of a physician which can be either on a phone or if she has symptoms that is fever above 100-degree Fahrenheit, severe aches, drowsiness, loss of smell and taste, persistent cough, oxygen saturation below 93 per cent, difficulty in breathing, and loose motion then she may be shifted to a hospital.


If she has a fever of less than 100-degree Fahrenheit, she can take Paracetamol tablets safely and if she has aches and pains she can be easily treated on the phone. If her fever comes down, her condition improves, her respiration is smooth, she will feel better and her RT-PCR comes negative and she will be normal. 


However, if a patient's condition worsens, if she has a fever which is now becoming a high-grade fever that is above 100-degrees Fahrenheit, and her Oxygen saturation is coming down below 93 per cent or less, she should not waste her time and immediately contact her physician who will get her admitted in the hospital. For such patients, we do chest X-Ray or CT, and proper shielding is done on the patient to lessen the harm to the fetus because life comes first.


What effect does Covid-19 have on pregnant women?

The way a pregnant woman reacts to the Covid-19 infection is the same as the general population. That is, she may completely remain asymptomatic, or she may develop fever or pneumonia. But regarding the fetus or the pregnancy itself, previously it was known that the vertical transmission (from mother to fetus) was not there, but current data suggests it is probable; the mother may transmit this infection to the baby. 


Some patients go into preterm labour, otherwise, it does not affect pregnancy as such. Pregnant women should understand that their body undergoes immunological changes which pre-disposes and makes them more prone to develop infection viral as well as bacterial.


Those patients who have added co-morbidities (additional health problems like heart disease, obesity, respiratory illness, diabetes, hypertension, immuno-compromised, taking certain drugs or anaemic) are at increased risk of developing a more serious form of Covid-19 infection which can affect the fetus as well as the mother, especially in the third trimester.


A pregnant woman who has no co-morbidity will respond to the Covid-19 as any other woman. That means those patients who have added co-morbidities, need to be very careful. Those patients should not come out of their houses and they must wear masks even at home, maintain personal hygiene, and should not be touching their faces often, and maintain a distance of 1 metre from other family members. Those patients should be in contact with their doctor on the phone and until and unless it is a necessity she should not even visit the clinic.


What effect does Covid-19 have on the baby if the mother is infected with it?

If she is asymptomatic, she can hold the baby maintaining SOPs. She can lactate her baby provided she takes all the care like she should wear a double mask because this virus has not been seen to be getting secreted into the breast milk. If the mother is symptomatic, expressed milk should be given to the baby. A patient who is Covid-19 positive does not unnecessarily need an abdominal delivery. It is not an indication for a severe infection until and unless it is so serious that her immediate delivery is needed to improve her respiratory status. If other parameters are normal, the patient can deliver and even go for vaginal delivery.


What research is being done to monitor the effect of Covid-19 on pregnant women and their babies?

The pandemic affects all pregnant and non-pregnant women. General continuous research on whether this pandemic affects the babies, what are the long-term effects of Covid-19 on mothers and children is being done all over the world.


The research is on for administering nasal vaccines through the nasal route, which is an ongoing process, and our community will be informed of any improvement or breakthrough in patient management. The government of India has now recommended the Covid-19 vaccine for lactating mothers, but even now there is no recommendation by ICMR (Indian Council of Medical Research) for pregnant women. It is still being withheld because we do not know the long-term implications of this vaccine on pregnant women and their babies. There are no recommendations as per this date for pregnant women. We are waiting. We have lost some mothers and their babies and lost some doctors who were pregnant. This is an issue that needs larger clarification and better research to see if it is safe for pregnant women and all doctors are waiting till the guidelines come. Flu Vaccine is highly recommended because of the altered immunological status of pregnant women.


Are pregnant women in a vulnerable group?

Yes, pregnant women are in a vulnerable group because their immunological status is altered during pregnancy. That is why they are more prone to develop any infection during pregnancy and especially those women who have added risk factors that are added comorbidities.


Should a pregnant lady take Vitamin-D supplements?

Vitamin-D supplements are needed only if she has a deficiency of Vitamin-D otherwise these supplements should not be taken. During pregnancy, instead of 60000 international units, only 2000 have to be taken per day. Pregnant women should not self-medicate and do not take unnecessarily large doses of Vitamin D. It can be harmful to both the mother and baby. They should not take these matters into their own hands. Until and unless pregnant women have a deficiency and their doctors have prescribed it, they can take it. 


Are some pregnant women more at risk of becoming seriously unwell from Covid-19 than others?

No, pregnancy does not predispose to the severity until and unless she has other comorbidities otherwise a healthy pregnant woman is not vulnerable to develop severe Covid-19 and her chance of developing severe Covid-19 depends on any other high-risk factors.


Can a woman get the Covid-19 vaccine if she is trying to get pregnant?

Of course, she can. There is no problem with that. The recommendation is that after the vaccination she can wait for two to three months and then she can easily conceive. Better is to take both the doses and wait for two to three months for antibodies to develop so that even if you get pregnant, you can ward off Covid and can manage the pregnancy with ease.


Any message from your side for the expecting mothers?

The message I want to give pregnant women is that once they become positive, they need not unnecessarily worry, please keep your cool and follow the directions given to you by your physician/obstetrician. And understand it is only 2% of patients who develop serious disease, otherwise, 98% of patients do well and they recover fully.

• Please do not go out unnecessarily.

• Take all the precautions even if you are at home.

• Maintain distance with the members of the family who go out because of their work.

• If you are a working lady, prefer to work from home.

• Wear a double mask, maintain hand hygiene, take a good diet, be positive, be in touch with your physician as well as an obstetrician online.

• Minimize your antenatal visits until and unless you have high-risk factors.

• Do not self-medicate.

• Do not go to hospitals unnecessarily.

• Do not attend weddings or any other social gatherings.

• Take care of yourself, take medications regularly, meditate and enjoy this beautiful phase of your life.


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