Document Type : Letter to The Editor
Department of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
In this article, we reviewed and compareed some of COVID-19 and pregnancy guidelines, which is useful for pregnant women including who have a history of infertility specially who have undergone assisted reproductive techniques. The general advice given for prenatal care is to reduce face-to-face visits. All women who refer for prenatal visits should be evaluated for signs of the infection at the time of entry. The triage of suspected women should be separate from other patients. Outpatient monitoring with a 14-day self-quarantine can be considered for asymptomatic infected women and also for women with mild symptoms.
Inpatient management criteria include moderate to severe symptoms and the target level of oxygen saturation is considered between 92% and 95% in different guidelines. In the presence of fever, it is important to conduct a thorough examination of the other causes of the fever. It is important to monitor fluid intake and output, maintain fluid and electrolyte balance and prevent fluid overload. Thromboembolic prophylaxis is recommended. Corticosteroid administration in based on obstetrics indications, unless in severe critical ill cases which should be based on MDT decision. A positive COVID-19 result which lacks other obstetrics causes can not be considered as indicationfor delivery in mild and asymptomatic cases. In critically ill pregnant women, an individualized decision should be made about delivery time by the MDT. General anesthetic should be avoided unless inevitable for standard procedures such as intubation is an aerosol-generating procedure. There is agreement that babies born to infected mothers, even if isolated from the mother at birth, should be considered a close contact of the mother and tested for COVID-19 and also separated from other neonates. Breastfeeding is encouraged and hand hygiene and face mask during feeding is highly recommended by all guidelines.