Pregnancy in COVID times: When you’re expecting during a pandemic
Dr. Sherley Mathen, Senior Consultant- Obstetrics & Gynecology
Motherhood opens up new chapters in a woman’s life. As the entire family prepares to welcome a new member into its fold, no effort is spared to keep the expecting mother and her growing child in the best health.
Like other vulnerable categories, pregnant women are also susceptible to Covid-19. Extreme care should be taken by women who are due for deliveries during the pandemic.
High risk
The SARS- CoV-2 virus that causes Covid-19 has a special predilection for the cells that form the inner lining of blood vessels.
Therefore, organs that have a large number of blood vessels are particularly at risk. The placenta, a unique organ in pregnancy and is the source of nourishment for the growing fetus is highly vascular.
Therefore if the mother is tested positive for the virus, the probability of the fetus getting affected is also high.
It has been demonstrated that mothers infected by virus close to the time of delivery can infect the placenta.
A small percentage of neonates born to infected mothers acquire infection.
Vertical transmission, which is termed as direct infection from mother to fetus, reported so far is very low (2.3%). In some cases, babies may not develop clinical disease.
If the virus can infect the placenta in term pregnancy, it can also infect the placenta in the first three months (first trimester) of pregnancy.
Since that is the crucial period of development or organogenesis, it can lead to congenital abnormalities (structural and developmental).
According to WHO, there is no known difference between the clinical manifestations of Covid 19 in pregnant and non-pregnant women of reproductive age, but pregnancy leads to changes in the body that may increase the risk of infection.
A complication of infertility in males also cannot be ruled out with the new strand of the Covid virus.
There are receptors in the male testes which are capable for the virus to bind with the cells making male genital tract susceptible to infection.
So like other viruses, Covid-19 too can cause orchitis, inflammation of the testes and lead to male infertility which may be transient.
Fertility treatments on hold
Generally, infections including a fever would interfere with fertility treatments while undergoing ovulation stimulation.
If those with a high risk of Covid-19 infection are undergoing fertility treatments like ART (Assisted Reproductive Technology), it is better to freeze the embryos and oocytes until they are disease-free.
Precautions
It is better to postpone pregnancy planning if you have been diagnosed with Covid-19, till you completely recover. In the cases of unplanned pregnancies, there is no choice but to be cautious and take all the measures to not get infected.
Wearing masks and practising social distancing in public places is a must for the pregnant woman.
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