COVID-19: Pregnancy Guidance Updated for 3rd Time in a Week

Nicky Broyd

March 19, 2020

Many doctors were surprised when pregnant women were included in Government coronavirus at-risk groups.

That prompted the Royal Colleges who are experts in this field to issue statements saying the science had not changed.

Now the guidance for healthcare professionals has moved onto its third version.

Medscape UK asked the Royal College of Obstetricians and Gynaecologists (RCOG) what's new or changed in the latest guidance?

An RCOG spokesperson answered our questions by email.

Q&A

What's new or changed in the latest guidance?

The RCOG guidance has been updated to include Government special measures for pregnant women.

Pregnant women are now considered a vulnerable risk group and should reduce social contact where possible. Where pregnant women can work from home, they should do so.

We are working with the Government and should have clearer guidance around working arrangements for pregnant healthcare professionals due to be published shortly.

Was the RCOG surprised pregnant women were added to the Government's list of at-risk groups for isolation?

The Government has announced that women who are pregnant should limit social contact. This is purely a precautionary measure, to reduce the theoretical risk to the baby’s growth and a risk of preterm birth should the mother become unwell.

There is currently no new evidence to suggest that pregnant women are at a greater risk of coronavirus than other healthy individuals, or that they can pass the infection to their baby while pregnant.

It is important to note Government advice for pregnant women – who are not showing any symptoms – is not self-isolation. Pregnant women are still able to do things that are essential to daily life, such as taking their children to nursery or school, and attend antenatal appointments which are essential to ensure a woman and her baby’s wellbeing.

Is the guidance ahead of the science, keeping pace, or lagging?

The RCOG clinical team is continually reviewing the latest evidence available and updating guidance for women and healthcare professionals.

How hard is it for colleagues to reassure women worried about the risks?

Currently no evidence suggests that pregnant women are at a greater risk of coronavirus than other healthy individuals, or that they can pass the infection to their baby while pregnant. It is important to reassure pregnant women, but also advise them to take precautionary measures, such as limiting social contact where possible, to avoid risk of transmission.

Are there special arrangements in hospitals or maternity units?

The NHS is making arrangements to ensure that pregnant women are supported and cared for safely through pregnancy, birth, and the period afterwards, even during this epidemic.

Maternity units are increasingly providing consultations via phone or video link, when appropriate, so pregnant women do not have to travel unnecessarily to the hospital. Elective gynaecology operations are being postponed and, in many units, arrangements are being made for gynaecology doctors to work in the maternity unit.

Areas are being designated for women with known or suspected COVID-19 infection. Teams of doctors and midwives are carrying out regular drills to prepare for caring for women with this infection, including dealing with emergency obstetric situations.

What information do you need from collected global experiences to make further changes?

Currently, the amount of information we have on the outcomes for pregnant women with COVID-19 and their babies is reassuring, but sparse. We are very keen to see more published evidence as soon as possible. We know that doctors in the most severely affected areas are very busy indeed and it is difficult for them to find the time to collate, write up and publish their data. But we are encouraging them to do so as soon as they can, so that we and others around the world can base our recommendations on more robust evidence.

Virtual Antenatal Courses

In another development, the childbirth charity NCT is moving its antenatal courses online instead of face-to-face.

NCT Chief Executive Angela McConville said in a statement: "We want to support mums- and dads-to-be at a very stressful time while taking on board Government guidance about social distancing. So this week we’ve launched our antenatal classes in a virtual format and will be providing online courses for the foreseeable future. Expectant parents need social connection now more than ever.

"Our new courses are interactive, engaging and social and provide an essential lifeline in these worrying times. Our experienced course leaders continue to provide essential evidence-based information about pregnancy, birth, and the early days with a newborn. They’re still local so also enable new mums and dads to build a community support network of other parents having a baby at the same time."

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....