Should mothers with COVID-19 be separated from their babies?
Pregnant lady with COVID-19 (II.)
Can an asymptomatic
partner/support person attend labor & delivery?
This is practicably
variable. At least, the supportive person should be screened first according
to the local policy, and subjects with:
1)
any Sms consistent e
COVID-19,
2)
exposed to a confirmed case through 14 d., or
3)
+ve test for COVID-19 through 14 d.
Should NOT be permitted to attend the labor &
birth.
Most facilities recommend
that a supportive subjects is important to many laboring women and allow one supportive subject who
must attend with the laboring lady (may NOT leave the labor room and
then return). Further supportive subjects may be permitted or can be a part of
the ptn's labor & delivery through a video.
POSTPARTUM: How
should the baby be evaluated?
If the mother
with a documented COVID-19 infection,
the infant is a COVID-19 suspect and
should be examined for COVID-19,
isolated from healthy infants, and managed accordingly to infection control measures for ptns with confirmed/ suspected COVID-19 infection.
Should mothers with COVID-19 be separated from their babies?
Generally speaking, NO as the newborn's
risk to acquire SARS-CoV-2 from his/her
mother is currently low, and the available data suggest that there is no difference in risk of neonatal SARS-CoV-2
transmitted infection whether this neonate is currently cared in a separate room or
still remaining in his/her mother's room. However, nursing mothers must wear a mask with the
necessary hand hygiene within caring their babies. Physical distance
more than 6 feet between
the mother & the baby or keeping the baby in an incubator is advised, however, after contact.
How long mother-baby
precautions at home should be continued after recent infection?
Prior symptomatizing
mother with suspected/confirmed COVID-19 are
NOT considered
a possible risk of viral
transmission to their babies if
they hv met the criteria to hold discontinuing isolation and precautions:
v At least 10
d. should pass since their Sms firstly manifested (up to 20 d. if they hv
more intense clinical illness or are seriously immunocompromised).
v At least 24
h. hv passed since last feverish episode with no antipyretics use.
v Other symptomatology have been ameliorated.
Asymptomatic
mother recognized only by obstetric
screening testing, at least 10 d. should have elapsed since the last positive testing.
Can breast milk
transmit SARS-CoV-2?
Generally,
breastfeeding should be advised owing to its several maternal &
infant benefits.
It’s uncertain whether SARS-CoV-2 can
be transmitted through breast milk feeding as a few breast
milk samples hv bn examined. In a
WHO report, breast milk samples taken
from 43 mothers
were negative for SARS-CoV-2 by the RT-PCR)
& samples from 3
mothers tested +ve,
but the particular tests for viable & infective
virus have not been adressed.
What are the precautions
should mothers with confirmed / suspected COVID-19 take
when breastfeeding?
Droplet
viral transmission from infected
mothers to their babies is
currently possible via close contact during breastfeeding
their babies. Mothers may consider the necessary precautions through
hand & breast hygiene and the use of a face
mask. In a New York City report testing 82 baby of 116 mo who tested +ve for SARS-CoV-2, No one baby was +ve for SARS-CoV-2 post-natally, despite that most
roomed-in with their mothers and on breastfeeding. The baby was kept in a closed isolette while
rooming-in, and his mother wore a surgical mask while handling their babies and was following
frequent hand & breast washing measures.
Alternative
procedure is that the infant can be fed an expressed
breastmilk by a healthy caregivers
following hygiene protocols until the mother has been completely recovered.
In such cases, the mother should use strict
handwashing prior to pumping and with
wearing a face mask within pumping procedure.
Can pregnant &
postpartum lady with COVID-19 take NSAIDs &
acetaminophen?
The answer is Yes, NSAIDs agents & acetaminophen can be administrated
to control fever & pain
during pregnancy & postpartum.
The lowest
effective dose should be administrated.
In ptns with abnormal liver profile due to COVID-19,
a particular concern of acetaminophen therapy is hepato-toxic; however, a dose < 2 g./d. are likely safe in absence
of advanced
or severe hepatic failure. Concern
about possible negative effects of NSAIDs
was provided by anecdotal reports of a few young,
non-pregnant ptns receiving NSAIDs (ibuprofen)
early in
the course of infection and experienced intense disease.
Subsequent clinical
or population-based data on risk of NSAIDs
in COVID-19 still limited. Given this uncertain findings, acetaminophen administration
as a preferred analgesic if possible, and if NSAIDs
are needed, the lowest
effective dose must be utilized. The American
College of Obstetricians & Gynecologists, the European
Medicines Agency, & the WHO, ALL recommend not
to avoid NSAIDs if it is clinically indicated.
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