Testing positive for Covid-19 during pregnancy

Dr. Shiva Harikrishnan, Consultant - Obstetrics & Gynaecology, Medcare Women & Children Hospital

What happens if a woman is tested COVID positive in her early or mid-pregnancy?

A pregnant woman, tested COVID positive is considered under the ‘high risk category’. As per WHO guidelines, she should be admitted to the hospital once she is tested positive. If she is asymptomatic, she can self-isolate at home else stay in isolation in a hospital.

According to the UAE National guidelines once a pregnant women is tested positive, even if they are asymptomatic, they need to be kept in isolation at a hospital till two tests come negative.    

There is no data to support an increased risk of early pregnancy loss and pre-term birth and being COVID – 19 positive is not known to cause any abnormalities in the growing foetus and also does not affect the baby while passing through the birth canal during the process of delivery.

What happens when a pregnant women is COVID positive around the time of delivery?

If a woman tests positive she should be admitted in the hospital around the time of delivery and try not to induce and deliver during the period. However, if she has indications to deliver, medical staff should adhere to the protocols to ensure protection of the pregnant woman and her baby along with the attending staff. They can be allowed to have a normal vaginal delivery; as elective caesarean section is not necessary in COVID patients.

What can COVID positive mothers expect right after delivery of their baby?

When COVID positive pregnant women go into labour, close monitoring of the baby using continuous electronic fetal monitoring is advised. Close supervision of the woman especially for the oxygen level will also be conducted.

Mode of birth should not be influenced by the presence of COVID-19, unless the respiratory condition of the mother demands urgent delivery. In that case, caesarean section should be performed. Till now there has been no evidence of perinatal transmission of COVID infection to the baby while passing through the birth canal, hence caesarean delivery is reserved only for obstetric indications.

According to international guidelines, only one birth partner is allowed to be with the woman in labour. It is advisable to conduct a COVID test for the partner if he wants to be with the laboring mother and follow protocol of wearing mask and gloves and hand hygiene.

COVID positive mothers need not be separated from their baby, the baby can be kept in the same room at a safe distance from the mother.

Is it advisable for a COVID positive mother to breastfeed her newborn?

The main risk for infants of breast feeding is the close contact with a COVID positive mother, who is likely to share infective airborne droplets. The mother must wear protective masks and keep her head away from the face of the baby while breast feeding.

Feeding mothers must practice hand hygiene i.e. to wash her hands with soap and water and sanitize them before handling the baby. They are advised to avoid coughing or sneezing on or around the baby while feeding.

In another alternative the mother can pump her breast milk and allow a caretaker, who is physically well, to feed her baby. If a mother pumping breast milk in a hospital, a dedicated breast pump should be used which must be sanitized after every use.

Are there any dos or don’ts for pregnant  women and their husbands if the women or husband is COVID positive ?

• Pregnant women should avoid going out of their homes as much as possible
• Working woman should opt for working from home if their nature of work permits.
• Keep safe social distancing of at least 1 meter outside and even at home. Safe distancing is more important especially in the third trimester of pregnancy.
• Preferably to stay at home in one room with proper ventilation and washroom facility
• Wash hands as much as possible with soap and water or sanitizer for at least 20 seconds.
• Not to touch one’s face, nose, eyes or mouth unnecessarily
• Staying home doesn't mean that one can stay awake late at night and get up very late, which will affect proper hydration and nutrition system of the pregnant woman
• Great importance is to be given to consume plenty of warm water, fruits and vegetables.
•  Try to avoid watching negative information on social media and television; instead be engaged  in doing positive things in life like yoga, meditation, reading and listening to good music.

If the husband or family member has tested positive they need to follow quarantine rules and try to keep away from the pregnant women till it is safe.