Prehospital Considerations for patients with Confirmed COVID19 Disease

Pregnant patients who have confirmed COVID-19 should notify the obstetric unit before admission so that the facility can make arrangements for appropriate infection control preparations (e.g., identifying the isolation room, labor and delivery arrangements, personal protective equipment for the healthcare professionals,

During Hospitalization

1. Healthcare facilities should ensure recommended infection control practices for hospitalized pregnant patients who have confirmed COVID-19.
2. All healthcare facilities that provide obstetric care must ensure that their personnel are correctly trained and capable of implementing recommended infection control interventions.
3. Mode of delivery should be discussed with the patient and doctor and all appropriate measures should be taken to prevent the infection.

Care for Mother and Infant

1. At present it is not clear weather newborns with COVID-19 are at increased risk for severe complications.
2. Transmission after birth via contact with infectious respiratory secretions is a concern.
3. To reduce the risk of transmission of the virus that causes COVID-19 from the mother to the newborn, facilities should consider temporarily separating (e.g., separate rooms) the mother who has confirmed COVID-19
1. The risks and benefits of temporary separation of the mother from her baby should be discussed with the mother.
2. A separate isolation room should be available for the infant.
3. Healthcare facilities should consider limiting visitors, with the exception of a healthy parent or caregiver.
4. Visitors should be instructed to wear appropriate PPE, including gown, gloves, face mask, and eye protection gloves, face mask, and eye protection.
5. The decision to discontinue temporary separation of the mother from her baby should be made on a case-by-case basis.

Corona-Virus (COVID-19) Disease and Breastfeeding

1. During temporary separation from mothers following birth of child, who intend to breastfeed should be encouraged to express their breast milk to establish and maintain milk supply. If possible, a dedicated breast pump should be provided. Prior to expressing breast milk, mothers should practice hand hygiene.1 After each pumping session, all parts that come into contact with breast milk should be thoroughly washed and the entire pump should be appropriately disinfected per the manufacturer’s instructions. This expressed breast milk should be fed to the newborn by a healthy caregiver.
2. If a mother and newborn do room-in and the mother wishes to feed at the breast, she should put on a facemask and practice hand hygiene before each feeding.

A per now, very limited information is available about the COVID19 and its impact on infants:

1. Can COVID-19 be passed from a pregnant woman to the foetus or new-born?
1. Currently there are NO specific information about the transmission
2. Pregnant women in Wuhan, China, with COVID-19 pneumonia, No evidence of transplacental or perinatal viral transmission was detected
2. There have been a small number of reported problems with pregnancy or delivery (e.g. preterm birth) in babies born to mothers who tested positive for COVID-19 during their pregnancy
3. Currently there are NO specific guidance by CDC, the virus has not been detected in breast milk; however, it is not clear whether mothers with COVID-19 can transmit the virus via breast milk.