Pregnancy-related COVID-19 guidance

TThe International Society for Ultrasound in Obstetrics and Gynecology (ISUOG) has released interim guidance to medical professionals on management of COVID-19 in pregnancy. Joshua A. Copel, MD, professor and vice chair of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine—and a past president of ISUOG—is a co-author.

While the guidelines in the document are directed toward clinical caregivers, they also contain valuable knowledge for pregnant women and their loved ones. Copel says that although information on the virus is still highly limited, enough is already known—especially from experience in Asia—about how it can adversely affect pregnant women. "High fevers early in pregnancy could lead to problems like birth defects or miscarriage," he says, "and high fever and dehydration in the second or third trimester could lead to preterm labor. We need to figure out how to test pregnant women, when they need to be cared for in a hospital versus being cared for at home, and how to take care of them when they are in labor. Those are the biggest things."

Care teams also face other substantial challenges. Copel says one is self-protection, which can be difficult if the mother who is delivering is infected with the virus. Copel notes that the nature of obstetrics is such that hospitals and outpatient practices must remain available to patients at all times. "Obstetrics doesn't stop, ever, so we have to maintain enough staff, healthy, at facilities across the country. If all of a sudden 60% of the staff is either sick or under investigation and on home isolation, we have real problems dealing with situations both during the pregnancy and at the time of birth." The guidelines include best practices for minimizing those absences. If anything, Copel says, the guidelines may be overcautious, but with so much still unknown about the coronavirus, "we would rather be cautious that cavalier about it."

Copel has basic advice for pregnant women. "Wash your hands, wash your hands, wash your hands! Avoid people who are sick. Don't go out if you are sick. Call your doctor or midwife if you are sick. Don't go to their office. Call them instead." Yale Medicine also has a hotline dedicated to questions about COVID-19. The hotline number is 203-688-1700.

ISUOG is an international professional society with 15,000 members, focused on making sure that women around the world have access to the highest quality ultrasound services throughout their lifetimes.