The
SARS-CoV-2 pandemic has emerged as an unprecedented challenge to the current
medical practice, including obstetrics. Being an acute situation, there is limited
experience of the impact of COVID-19 in pregnancy. Various management protocols
are being evaluated and modified frequently to address key concerns of maternal
and neonatal health. Pregnancy is a unique bundle of two lives, and the physiological
adaptation to the dual life adds to the uniqueness. The effect of COVID- 19 and
its treatment on pregnancy (mother and fetus) and vice-versa, is a common quest
for all pathologies. The other concerns are vertical and horizontal
transmission in antepartum, intrapartum, and postpartum periods, respectively.
The immunosuppression as a part of physiological changes during pregnancy
apparently raises apprehension of higher risk of viral infection or probability
of severity of infection during pregnancy. The same has also been observed with
previous virus infections in history like severe acute respiratory syndrome
(SARS), Middle East respiratory syndrome (MERS), etc.,
although available literature suggests that the risk of developing COVID-19 for
pregnant women is not similar to the non-pregnant adult population. The small
risk of developing a serious condition during pregnancy is inevitable, and the
contagiousness of the virus is a major concern for the neonate and attending
family. Some overlapping features of complicated pregnancy with severe COVID-19
require attention. Social distancing, anxiety, and psychological stress need to
be kept in mind. There is an impact of financial stress on family; domestic
violence can also not be undermined during this crisis period. Access to health
facilities may also be affected in developing countries due to the lockdowns,
quarantine of pregnant women, caretakers, or health care workers (HCW), etc. The
aerosol production during the intrapartum phase is challenging for both vaginal
and abdominal routes of delivery, but the management of sudden catastrophic,
life-threatening conditions associated with pregnancy can be a real threat for
the team of health care workers. It is still early to comment on the long-term
effects of the viral infection on the foetus, especially the exposure during
the rapid embryogenesis period.
Keywords: ACOG advisory, Aerosols, Aerosol Generating Procedure (AGP), Corona Virus Disease, COVID-19, COVID and Preeclampsia, COVID Pneumonia, COVID-19 Transmission, Droplet Infection, Infant Mother Dyad MERS, Pandemic, PPE, N95, Nasopharyngeal Swab, Respirator, RT-PCR, SARS-CoV-1, SARS-CoV-2, Surface Fomites, Surgical Mask, Temporary Separation, Vertical transmission in COVID-19.
