The Management of Covid-19 Infection in Pregnancy and Puerperium: From the World View to the Italian Reality
Main Article Content
Abstract
Coronavirus disease 2019 (Covid-19) is characterized by severe acute respiratory syndrome and is an emerging disease. Considering the changes in maternal physiological and immune function during pregnancy, pregnant women may be at increased risk of being infected with Covid-19 and developing more complicated clinical events. Vertical transmission of the Covid-19 virus is possible although to this day it is still considered a rare event. It is conceivable that most pregnant patients infected with the Covid-19 virus have mild or moderate flu symptoms. More serious symptoms, such as pneumonia, in fact, seem to be more common in the elderly population or in subjects suffering from chronic diseases. As a precaution, pregnant women are considered the most vulnerable and therefore isolation and limitation of contact are recommended. At the moment there are no data to indicate whether spontaneous delivery is preferable in case of coronavirus infection (suspected or confirmed) to a cesarean section. However, in case of breathing difficulties that require delivery as soon as possible, a cesarean section is recommended. There is no evidence that the virus can be transmitted through breast milk. Furthermore, breastfeeding is preferable and has numerous benefits for the newborn's immune system. Since pregnant people appear to have a high risk of becoming seriously ill if they have an infection, vaccination is particularly important. In addition, there is evidence that vaccinated people have a lower risk of baby problems, such as stillbirth.
Keywords:
management, COVID-19, viral infection, SARS-CoV-2, pregnancy, gestational period, pandemics, vaccination, complication, adverse events, drugs
Article Details
How to Cite
CIARAMBINO, Tiziana et al.
The Management of Covid-19 Infection in Pregnancy and Puerperium: From the World View to the Italian Reality.
Medical Research Archives, [S.l.], v. 10, n. 11, nov. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3089>. Date accessed: 03 dec. 2024.
doi: https://doi.org/10.18103/mra.v10i11.3089.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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24. Li Y, Zhao R, Zheng S, Chen X, Wang J, Sheng X. et al. Lack of Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, China. Emerg Infect Dis. 2020;26(6):1335–1336.
25. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W. et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395:809–815.
26. Society for Obstetric Anesthesia and Perinatology. Interim Considerations for Obstetric Anesthesia Care Related to Covid-19. https://soap.org/education/provider-education/expert-summaries/interim-considerations-for-obstetric-anesthesia-care-related-to-covid19/. Accessed March 25. 2020.
27. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, Wasserman R. Newborns of COVID-19 mothers: short-term outcomes of colocating and breastfeeding from the pandemic's epicenter. J Perinatol. 2020;40(10):1455–1458.
28. Kyle MH, Glassman ME, Khan A, Fernández CR, Hanft E, Emeruwa UN, et al. A review of newborn outcomes during the COVID-19 pandemic. Semin Perinatol. 2020 Nov;44(7):151286. doi: 10.1016/j.semperi.2020.151286. Epub 2020 Jul 23. PMID: 32826081; PMCID: PMC7376345.
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31. Groß R, Conzelmann C, Müller JA, Stenger S, Steinhart K, Kirchhoff F, et al. Detection of SARS-CoV-2 in human breastmilk. Lancet. 2020 Jun 6;395(10239):1757-1758. doi: 10.1016/S0140-6736(20)31181-8. Epub 2020 May 21. Erratum in: Lancet. 2020 Sep 12;396(10253):758. PMID: 32446324; PMCID: PMC7241971.
32. Elshafeey F, Magdi R, Hindi N, Elshebiny M, Farrag N, Mahdy S. et al. A systematic scoping review of COVID-19 during pregnancy and childbirth. Int J Gynaecol Obstet. 2020; 150:47–52.
33. Salvatore CM, Han JY, Acker KP, Tiwari P, Jin J, Brandler M, et al. Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study. Lancet Child Adolesc Health. 2020 Oct;4(10):721-727. doi: 10.1016/S2352-4642(20)30235-2. Epub 2020 Jul 23. PMID: 32711687; PMCID: PMC7377726.
34. Raschetti R., Vivanti A.J., Vauloup-Fellous C., Loi B., Benachi A., De Luca D. Synthesis and systematic review of reported neonatal SARS-CoV-2 infections. Nat Commun. 2020; 11:5164.
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39. MacIntyre C.R., Veness B., Berger D., Hamad N., Bari N. Thrombosis with thrombocytopenia syndrome (TTS) following AstraZeneca ChAdOx1 nCoV-19 (AZD1222) COVID-19 vaccination—a risk-benefit analysis for people < 60 years in Australia. Vaccine 2021; 39:4784–4787.
40. MacNeil J.R., Su J.R., Broder K.R., et al. Updated recommendations from the Advisory Committee on Immunization Practices for use of the Janssen (Johnson & Johnson) COVID-19 vaccine after reports of thrombosis with thrombocytopenia syndrome among vaccine recipients—United States, April 2021. MMWR Morb Mortal Wkly Rep. 2021; 70:651–656.
41. Hedermann G, Hedley PL, Bækvad-Hansen M, et al. Danish premature birth rates during the COVID-19 lockdown. Arch Dis Child Fetal Neonatal Ed. 2021;106(1):93-95. doi:10.1136/archdischild-2020-319990
42. COVID RCOG 19 vaccines, pregnancy and breastfeeding. 2021. https://www.rcog.org.uk/en/guidelines-research-services/coronavirus-covid-19-pregnancy-and-womens-health/covid-19-vaccines-and-pregnancy/covid-19-vaccines-pregnancy-and-breastfeeding/ Available at: Accessed October 15, 2021.
43. Gray KJ, Bordt EA, Atyeo C, et al. Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study. Am J Obstet Gynecol. 2021;225(3):303.e1-303.e17. doi:10.1016/j.ajog.2021.03.023.
44. Prabhu M, Murphy EA, Sukhu AC, et al. Antibody Response to Coronavirus Disease 2019 (COVID-19) Messenger RNA Vaccination in Pregnant Women and Transplacental Passage Into Cord Blood. Obstet Gynecol. 2021;138(2):278-280. doi:10.1097/AOG.0000000000004438