Summary:
Corona virus disease 2019 (COVID-19) is a global pandemic
disease caused by novel corona virus called SARS-CoV-2.
Over 213 countries as of July 15, 2020, 13.1 million people
are affected by this deadly virus. More than 100 million
women are pregnant worldwide and potentially all are at
risk of exposure to SARS-CoV-2 infection. Coronaviruses
cause illness ranging in severity from common cold and
severe respiratory illness to death. Frequent manifestations
of COVID-19 include fever, cough, myalgia, headache, and
diarrhoea. Abnormal test result shows abnormalities on chest
radiographic imaging, lymphopenia, leukopenia, and
thrombocytopenia. Physiological changes during pregnancy
like altered immunity, reduced functional residual volume,
pressure on diaphragm by advanced gravid uterus may lead
to adverse respiratory outcome in any viral disease. Maternal
mortality was very high in other corona viruses like Severe
acute respiratory syndrome (SARS) and Middle East
respiratory syndrome (MERS). No evidence of in utero
transmission was seen in SARS or MERS. Coronavirus
disease 2019 might increase the risk of vertical transmission
and pregnancy complications. So, meticulous management
is necessary for safe maternal and foetal outcome. Early
isolation, aggressive infection control procedures, oxygen
therapy are the key component of COVID-19 management.
In pregnancy multidisciplinary approach should be taken
for general and obstetrical management. At present there is
no specific treatment for COVID-19. Based on results from
observational studies empiric antibacterial and antiviral
drugs are used. Very recently a few controlled trials were
published that suggest few treatment options. On the basis of
published data and recommendations of international health
organizations, the aim of this review is to explore effective
treatment and care of the pregnant women throughout
pregnancy, during childbirth and afterwards in this novel
SARS-CoV-2 crisis.
Keywords: COVID-19, Pregnancy, Childbirth.
(J Bangladesh Coll Phys Surg 2020; 38: 91-108)
DOI: https://doi.org/10.3329/jbcps.v38i0.47443