Obstetric Management of COVID-19 in Pregnant Women

Mei, Youwen; Luo, Dan; Wei, Sumei; Liao, Xiaoyan; Pan, Yue; Yang, Xiao; Lin, Yonghong

doi:10.3389/fmicb.2020.01186

Cited by 31 publications

(27 citation statements)

References 55 publications

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“…Some experts from Wuhan, China assumed that IVIG could be effective against severe COVID-19 cases when they used high doses (25 g/kg) for five days in combination with antiviral medications (ritonavir and lopinavir) and steroids (methylprednisolone). [32,33] Pediatric use of IVIG for severe COVID-19 cases was reported in China. However, World Health Organization (WHO) has not recommended IVIG or a specific therapeutic agent in children yet until the final results of ongoing clinical trials are released.…”

Section: Cross-reactivity Of Immune Responsementioning

confidence: 99%

Speculations of Immunotherapy in COVID-19 Patients with Practical Applications During Childhood and Pregnancy

Al-Momen

Jasim

Al-Ameri

2020

Al-Kindy Col. Med. J

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The rapid spread of novel coronavirus disease(COVID19) throughout the world without availablespecific treatment or vaccine necessitates alternativeoptions to contain the disease. Historically, childrenand pregnant women were considered high-riskpopulation of infectious diseases but rarely have beenspotlighted nowadays in the regular COVID-19updates, may be due to low global rates of incidence,morbidity, and mortality. However, complications didoccur in these subjects affected by COVID-19. Weaimed to explore the latest updates ofimmunotherapeutic perspectives of COVID-19patients in general population and some added detailsregarding pediatric and obstetrical practice.Immune system boosting strategy is one of therecently emerging issues allowing the body defensemechanism to produce virus-neutralizing antibodies tocounteract the viral impacts on multiple organdamage. Measles vaccination (which is universallyused for children in many countries, butcontraindicated during pregnancy) could urge thebody to produce these antibodies which may applytheir effects through cross-reactivity of measlesvaccine and COVID-19 antigenic proteins. Inaddition, intravenous immunoglobulin andconvalescent plasma could have such neutralizingantibody effect leading to clinical improvement andviral elimination. Pediatric and obstetrical experiencehas appeared in previous publications.Human monoclonal antibodies are the futurepromising approach to treat and prevent COVID-19with the use of tocilizumab in recent studies. Pediatricdata are still in progress while no pregnancy ongoingtrials are planned up to date.The better understanding of the host antiviral responsemay pave the way to develop immunotherapeuticplans against COVID-19 in the near upcoming days.

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Section: Cross-reactivity Of Immune Responsementioning

confidence: 99%

Speculations of Immunotherapy in COVID-19 Patients with Practical Applications During Childhood and Pregnancy

Al-Momen

Jasim

Al-Ameri

2020

Al-Kindy Col. Med. J

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“…The anatomical, physiological and immunological changes accompanying pregnancy may raise pregnant women's susceptibility to viral pathogens and increase the risk of developing severe pneumonia [3,4] . Evidence from other coronavirus infections, such as SARS-CoV or MERS-CoV, suggests that infected pregnant women might be more susceptible to adverse outcomes, including intubation, intensive care unit (ICU) admission, renal failure and death [5].…”

Section: Introductionmentioning

confidence: 99%

SARS-COV-2 infection in pregnant women and newborns in a Spanish cohort (GESNEO-COVID) during the first wave

Carrasco

Muñoz-Chapuli

Vigil‐Vázquez

et al. 2021

BMC Pregnancy Childbirth

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Background Knowledge about SARS-CoV-2 infection in pregnancy and newborns is scarce. The objective of this study is to analyse clinical and epidemiological characteristics of a cohort of women infected with SARS-CoV-2 during pregnancy and their newborns exposed to SARS-CoV-2 during gestation. Methods Multicentric observational study of Spanish hospitals from the GESNEO-COVD cohort, participants in RECLIP (Spanish Network of Paediatric Clinical Assays). Women with confirmed SARS-CoV-2 infection by PCR and/or serology during pregnancy, diagnosed and delivering during the period 15/03/2020–31/07/2020 were included. Epidemiological, clinical, and analytical data was collected. Results A total of 105 pregnant women with a median of 34.1 years old (IQR: 28.8–37.1) and 107 newborns were included. Globally, almost 65% of pregnant women had some COVID-19 symptoms and more than 43% were treated for SARS-COV-2. Overall, 30.8% of pregnant women had pneumonia and 5 (4.8%) women were admitted to the intensive care unit needing invasive mechanical ventilation. There was a rate of 36.2% of caesarean sections, which was associated with pneumonia during pregnancy (OR: 4.203, CI 95%: 1.473–11.995) and lower gestational age at delivery (OR: 0.724, CI 95%: 0.578–0.906). The prevalence of preterm birth was 20.6% and prematurity was associated with pneumonia during gestation (OR: 6.970, CI95%: 2.340–22.750) and having a positive SARS-CoV-2 PCR at delivery (OR: 6.520, CI95%: 1.840–31.790). All nasopharyngeal PCR in newborns were negative at birth and one positivized at 15 days of life. Two newborns died, one due to causes related to prematurity and another of unexpected sudden death during early skin-to-skin contact after delivery. Conclusions Although vertical transmission has not been reported in this cohort, the prognosis of newborns could be worsened by SARS-CoV-2 infection during pregnancy as COVID-19 pneumonia increased the risk of caesarean section deliveries and preterm births.

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“…The study will also benefit everyone, especially the vulnerable group in this Pandemic, like pregnant women (Mei et al, 2020). It will draw attention of health workers, especially midwives, pregnant women, community and family heads to the prevention of stillbirth (Zhu et al, 2020;Alberca et al, 2020;Mei et al, 2020) or preterm delivery (Skhan et al, 2020;Mullins et al, 2020) due to COVID-19.…”

Section: Justification/relevance/ Rationale Of the Studymentioning

confidence: 99%

“…If people are not willing to protect themselves and others by wearing face masks; people, especially those with underlined health conditions (Chow, 2020;, pregnant women (Mei et al, 2020), and the elderly (Perrotta et al, 2020;Mueller et al, 2020), would suffer more, since they are the most vulnerable. COVID-19 would also stay with us for long (Shaban & Mumbere, 2020) if people are not ready to observe safety protocols like the wearing of face masks.…”

mentioning

confidence: 99%