The complete guide to COVID-19 and pregnancy: Women’s top 23 questions answered

The complete guide to COVID-19 and pregnancy: Women’s top 23 questions answered

6/12/2021 2:20:00 AM

The complete guide to COVID-19 and pregnancy: Women’s top 23 questions answered

What do you do if you get COVID-19 while you’re pregnant? CNA Women puts together this one-stop guide to answer all your questions, from what to do the moment you test positive, to whether you’ll have to be separated from your newborn after birth.

The recent discovery of a new COVID-19 variant, which the World Health Organization (WHO) named Omicron, has sent countries around the world into a state of anxiety.And because much is still unknown about it, it is also proving to be worrying for obstetricians, Dr Ng Kai Lyn, a consultant obstetrician and gynaecologist at the Advanced Centre for Reproductive Medicine (ACRM) Gleneagles, told CNA Women.

If you are fully vaccinated, aged 35 and below, have an uncomplicated pregnancy that is less than 26 weeks gestation and have no other medical problems, you may be eligible for the Home Recovery Programme (HRP). (Photo: iStock/ferlistockphoto)“Our worst fears would be that our pregnant women, already a vulnerable population in the pandemic, will once again bear the brunt of morbidity and mortality ... as Omicron makes its rounds,” said Dr Ng, adding that with the Delta variant, studies have shown increased morbidity in pregnancy.

“We are bracing for the possibilities of high transmissibility, increased risk of reinfection and vaccine resistance, when we have barely made it past the Delta variant,” she said.We are bracing for the possibilities of high transmissibility, increased risk of reinfection and vaccine resistance, when we have barely made it past the Delta variant.

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THE DELTA VARIANT REMAINS A HUGE CONCERNDr Ng’s worries about the Omicron variant are not unfounded, given that the Delta variant fuelled a surge in COVID-19 cases in Singapore in recent months.Case in point: Just between September and October, National University Hospital (NUH) had five mothers who were COVID-19 positive at the time of delivery, according to Associate Professor Zubair Amin, head of the Department of Neonatology at Khoo Teck Puat – National University Children's Medical Institute, who spoke at a public forum webinar on pregnancy and COVID-19 back in October.

This year saw a sharp rise of pregnant women who fell sick with COVID-19. (Photo: iStock/staticnak1983)Compare this to all of 2020, he said, where NUH cared for around eight pregnant women who were infected with COVID-19 at various stages of pregnancy.

None had the virus at the time of delivery, Assoc Prof Zubair added, and all managed to deliver healthy babies and breastfeed too.“This is a traumatic change ... and from what I understand from the rest of public hospitals, situations have been pretty much the same,” he said.

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Similarly, Professor Tan Hak Koon, Chairman of the Division of Obstetrics and Gynaecology at KKH Women’s and Children’s Hospital (KKH), told CNA Women that the hospital saw 91 cases of pregnant women infected with COVID-19 at the in-patient wards, from May to October this year.

“This is a significant rise as compared to a few cases during the same period in 2020. What is most worrying is that the majority of this group of pregnant women infected with COVID-19 were unvaccinated or partially vaccinated,” Prof Tan said.In a move to

help Singapore transition to endemic living, MOH had announced on Oct 23 that home isolation would be the default mode of recovery for those with COVID-19. Pregnant women who are below 35 years old and less than 26 weeks pregnant qualify for the Home Recovery Programme (HRP).

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But questions abound, including: If I am in early pregnancy but have complications, am I eligible for isolation at the hospital? What is the risk that I could transmit the virus to my unborn baby, regardless of where I am in my pregnancy?CNA Women asked the experts these and more questions about what happens if you get COVID-19 during pregnancy.

GETTING VACCINATED AND BOOSTER SHOTSI was going to be vaccinated then found out I was pregnant–should I still go ahead?Yes, you should still go ahead with the vaccination as evidence has proven that the vaccines are safe and effective in all stages of pregnancy, advised Dr Serene Thain, a consultant at the Department of Maternal Fetal Medicine at KKH.

“Pregnant women with COVID-19 infection are at increased risk of becoming severely unwell (for example, requiring oxygen, intensive care unit admission) if they catch COVID-19,” Dr Thain said. “They are also at higher risk of developing pregnancy complications such as preterm birth and stillbirth.”

The mRNA COVID-19 vaccine (Pfizer or Moderna) is recommended for pregnant women as robust real-world data demonstrates that mRNA vaccines are safe in pregnancy, said Dr Serene Thain of KKH. (Photo: iStock/Soumen Hazra)If a vaccinated pregnant woman catches COVID-19, she is 90 per cent less likely to develop severe or critical illness compared to an unvaccinated pregnant woman, said Dr Thain.

However, if you are in your first trimester and feel unwell due to early pregnancy symptoms, you may want to seek advice from your doctor before proceeding with vaccination, she added.What are the risks and benefits of vaccination for my unborn baby and me?

We now have very robust real-world data demonstrating that the mRNA vaccines are safe in pregnancy, said Dr Thain.“Over 170,000 pregnant women in the US have received an mRNA vaccination (either Pfizer BioNTech or Moderna) and there have not been any safety concerns raised,” she said.

The benefits, according to Dr Thain, include antibody production in pregnant women, which has been shown to be transferred passively across the placenta to the baby in pregnancy, which could confer protection to the baby after birth as well.Pregnant women with COVID-19 infection are at increased risk of becoming severely unwell if they catch COVID-19.

It’s also worth noting that mRNA vaccines are not live vaccines and therefore do not cause one to get infected with the virus, nor does it change the DNA or genetic makeup of the pregnant woman or her baby, she said.As for the risks, Dr Thain pointed out that the side effects from vaccination for a pregnant woman are no different from non-pregnant individuals.

“Side effects are temporary and common ones include pain at the injection site, muscle ache, fatigue or fever. These side effects are self-limiting and will go away in a few days with ample rest and adequate hydration.”RELATED:COVID-19 vaccination in women: Your top 17 questions answered

What if I get COVID-19 before I can get my second dose? When can I complete my vaccination – should I wait until I give birth?If you are partially vaccinated (or as yet unvaccinated), had an earlier COVID-19 infection and recovered, you are recommended to receive a single dose of the mRNA vaccine at least three months after the date of the diagnosis, said Dr Thain.

“There is evidence that a single dose of the mRNA vaccine would further boost immunity against COVID-19. A booster dose is not yet recommended at this time,” she added.THE EFFECT OF VACCINATION ON FERTILITY TREATMENTIf I am currently undergoing fertility treatment, should I delay getting vaccinated or taking the booster jab?

Couples should complete their COVID-19 vaccination before they start fertility treatment, if possible, said Dr Jessie Phoon, Director and Senior Consultant of KKIVF Centre at KKH.This is because any side effects or symptoms arising from the COVID-19 vaccination may disrupt their fertility schedule and treatment.

TESTING POSITIVEWhat’s the first thing I need to do if I test positive for COVID-19 on theAntigen Rapid Test (ART) at home?As pregnant women can become more severely ill with COVID-19 compared to non-pregnant women, you should get a confirmatory Polymerase Chain Reaction (PCR) test if you test ART positive, said Dr Lim Min Yu, President of the Obstetrical & Gynaecological Society of Singapore (OGSS).

If you're pregnant and test positive on the ART, the next step is to take a confirmatory PCR test at a nearby clinic. (Photo: iStock/Kandl)

Read more: CNA »

The most interesting part of this CNA article is that it indicates that pregnant women are more vulnerable to SARS-CoV-2 than non-pregnant women, and that the virus can damage the unborn foetus. Serious facts you would never hear about in western so-called 'conservative' media.

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