The coronavirus disease 2019 (COVID-19) pandemic has represented a major impact to health systems and societies worldwide. The generation of knowledge about the disease has occurred almost as fast as its global expansion. The mother and fetus do not seem to be at particularly high risk. Nevertheless, obstetrics and maternal-fetal medicine practice have suffered profound changes to adapt to the pandemic. In addition, there are aspects specific to and gestation that should be known by specialists in order to correctly diagnose the disease, classify the severity, distinguish specific signs of COVID-19 from those of obstetric complications, and take the most appropriate management decisions. In this review we present in a highly concise manner an evidence-based protocol for the management of CO-VID-19 in pregnancy. We briefly contemplate all relevant as-pects that we believe a specialist in obstetrics and maternal medicine should know, ranging from basic concepts about the disease and protection measures in the obstetric setting to more specific aspects related to maternal-fetal management and childbirth.[1]. With 220,000 infections and more than 22,000 deaths, Spain is the third country in number of cases [1]. In this paper, we aimed to share our management protocol and address considerations for maternal-fetal medicine practice based on a qualitative review of existing data. Disease TransmissionAvailable information [2] suggests that the infection was originally zoonotic. Still, the current transmission is person to person by respiratory droplets after contact with an infected person (< 2 m) or direct contact with contaminated surfaces by infected secretions [3]. Transmission could also occur through infected faeces, but the propagation throughout this route is much less relevant [4]. The possibility of vertical transmission is highly unlikely and has not been demonstrated in the Chinese CO-VID-19 outbreak [5] or in previous epidemics by other similar coronaviruses (severe acute respiratory syndrome [SARS]-CoV and Middle East respiratory syndrome [MERS]-CoV) [6,7]. Based on limited data, there is no evidence of the presence of the virus in genital fluids, urine, amniotic fluid, or breast milk [8]. The low maternal viremia found in this infection [9] also suggests a negligible placental seeding. However, most data on vertical transmission are based on women who had infection during the third trimester, and information regarding vertical transmission earlier in pregnancy is lacking.Reported cases of newborn infection probably came from horizontal transmission. The usual incubation period is about 4-6 days, which can vary between 2 and 14 days [10]. The median duration of viral shedding is 20.0 days (being the 75th centile at 24 days) [11].

Objective To describe sequential changes in uterine artery waveform between the first and second trimesters of gestation and to analyze their association with the subsequent risk of hypertensive disorders and fetal growth restriction (IUGR). Methods (OR, 10.7; 95% CI,). In addition, women in whom the uterine artery mean PI shifted from abnormal to normal between the two trimesters and women in whom the reverse shift occurred showed a similar intermediate risk (OR,5; 95% CI,), comparable to that in women with persistence of a bilateral notch (OR, 5.6; 95% CI,. Conclusions

Objective Cervical length screening by transvaginal sonography (TVS) has been shown to be a good predictive test for spontaneous preterm birth (PTB) in symptomatic singleton pregnancy with threatened preterm labor (PTL). The aim of this review and meta-analysis RR, 0.64 (95% CI,; three trials; 287 participants) and a later gestational age at delivery (MD, 0.64 (95% CI, MD, 4.48 (95% CI,