ROP 2020 May 10th Breaking News: Updates on COVID in Pregnancy

ROP Breaking News: COVID in Pregnancy - May 10, 2020 Updates

Penny Wilson, MD and Heidi James, MD

• The risk of COVID-19 to pregnant women is probably similar to the general age-matched population, but we know now that maternal mortality is not zero, so this virus should not be underestimated.
• Vertical transmission is still not conclusively shown but we have more indications from positive placental and amniotic fluid samples that it might be possible.
• Unsurprisingly, the mortality risk to the fetus or newborn appears to correlate with the severity of the maternal illness.
• Rates of asymptomatic carriage may be 8 or 9 times higher than symptomatic patients, so health services need to take that into account when considering screening and isolation policies.
• Keeping baby with mom and breastfeeding appears to be safe if appropriate precautions are taken.
• Don’t forget the PPE! 

References

Maternal Death Due to COVID-19 Disease
Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, et al. [published online ahead of print, 2020 Apr 28]. Am J Obstet Gynecol. 2020;S0002-9378(20)30516-0. doi:10.1016/j.ajog.2020.04.030

Preterm delivery in pregnant woman with critical COVID‐19 pneumonia and vertical transmission
Zamaniyan M, Ebadi A, Aghajanpoor Mir S, Rahmani Z, Haghshenas M, Azizi S. [published online ahead of print, 2020 Apr 17]. Prenat Diagn. 2020;10.1002/pd.5713. doi:10.1002/pd.5713

COVID-19 infection among asymptomatic and symptomatic pregnant women: Two weeks of confirmed presentations to an affiliated pair of New York City hospitals
Breslin N, Baptiste C, Gyamfi-Bannerman C, et al. [published online ahead of print, 2020 Apr 9]. Am J Obstet Gynecol MFM. 2020;100118. doi:10.1016/j.ajogmf.2020.100118

Universal Screening for SARS-CoV-2 in Women Admitted for Delivery
Sutton D, Fuchs K, D'Alton M, Goffman D. [published online ahead of print, 2020 Apr 13]. N Engl J Med. 2020;NEJMc2009316. doi:10.1056/NEJMc2009316

SARS-CoV-2 in pregnancy: symptomatic pregnant women are only the tip of the 2 iceberg
Accepted Manuscript - American Journal of Obstetrics & Gynecology www.ajog.org

Unlikely SARS-CoV-2 vertical transmission from mother to child: A case report
Peng Z, Wang J, Mo Y, et al. J Infect Public Health. 2020;13(5):818‐820. doi:10.1016/j.jiph.2020.04.004

SARS-CoV-2 Is Not Detectable in the Vaginal Fluid of Women With Severe COVID-19 Infection
Qiu L, Liu X, Xiao M, et al. [published online ahead of print, 2020 Apr 2]. Clin Infect Dis. 2020;ciaa375. doi:10.1093/cid/ciaa375

Second-Trimester Miscarriage in a Pregnant Woman With SARS-CoV-2 Infection
Baud D, Greub G, Favre G, et al. [published online ahead of print, 2020 Apr 30]. JAMA. 2020;e207233. doi:10.1001/jama.2020.7233

Detection of SARS-COV-2 in Placental and Fetal Membrane Samples
Accepted Manuscript - American Journal of Obstetrics & Gynecology MFM

Novel Coronavirus 2019 (COVID-19) - ACOG Practice Advisory

COVID‐19 vaginal delivery – a case report
Lowe B, Bopp B. [published online ahead of print, 2020 Apr 15]. Aust N Z J Obstet Gynaecol. 2020;10.1111/ajo.13173. doi:10.1111/ajo.13173

Vaginal delivery in SARS‐CoV‐2 infected pregnant women in Northern Italy: a retrospective analysis
Ferrazzi E, Frigerio L, Savasi V, et al. [published online ahead of print, 2020 Apr 27]. BJOG. 2020;10.1111/1471-0528.16278. doi:10.1111/1471-0528.16278