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Pregnancy and coronavirus: Doctor's Note



Being pregnant may be a worrying time for any mother-to-be, even when all is well.

They have to avoid certain foods - no more soft cheese and shellfish, for example - their bodies are changing dramatically and their normal routines can often be disrupted.

The uk is that the latest of variety of nations to incorporate pregnant women within the group of vulnerable people it's advising should "socially distance" themselves to cut back their chances of contracting coronavirus. Understandably, many pregnant women and their families are left feeling worried and confused.

The bottom line is that we don't yet know enough about how the COVID-19 disease caused by the new coronavirus affects pregnancy to draw any definite conclusions, but small numbers of pregnant women have contracted the virus and there's enough known for us to advise extra precaution for ladies who expect.

A weaker system
It was initially thought that in a pregnancy a woman's system is weakened making her liable to infections. However, like most things concerning the build, it's not that straightforward and newer evidence suggests that a woman's system is during a state of flux during her pregnancy, where at some points it's not as aggressive as normal and other times not.

This variable immune status during pregnancy is important to accommodate the developing baby - for various reasons at different stages of pregnancy. for example, within the early stages of pregnancy, the system should befits give implantation of what's, after all, a remote body. At other times, the system has to adjust again but during a different way, as an example when a adult body is preparing for labour.

This, of course, is an over-simplified explanation, but the purpose is that having a fluctuating system does put you at higher risk of the complications of COVID-19, like respiratory difficulties and even pneumonia.

The first thing to fret is that ladies should still attend all their antenatal hospital appointments unless told otherwise by their doctor or midwife.

For now, there's no reason to vary your birthing plan, whatever which will be, if you've got one. A birthing plan lays out what you're hoping for the birth - as an example, whether you would like to possess your baby reception or in hospital, and what varieties of pain relief you may want to possess.

However, if you develop symptoms that are in line with coronavirus - a persistent dry cough or a warmth - you need to self-isolate and speak together with your doctor or midwife.

Certainly, women who produce other health conditions and are pregnant must be extra vigilant and consider social distancing if not self-isolation during their pregnancy. Women who develop diabetes - a condition called gestational diabetes - as a results of their pregnancy should also make sure and limit social contact.

Being diagnosed with gestational diabetes already puts you during a higher-risk pregnancy group even without the coronavirus, because it increases your chances of complications during pregnancy and birth. Furthermore, high levels of blood sugars for a protracted period of your time - the result if gestational diabetes isn't diagnosed and managed properly - can weaken your system further.

For otherwise healthy pregnant women, given how the strength of their system varies during the trimesters, it might be prudent to require precautionary measures and consider social distancing where possible.

As plenty of pregnant women swallow partners and maybe have older children too, the identical advice applies to them - practice social distancing so you are doing not put your pregnant wife, mother, sister or aunt in danger.

This might include acting from home (for people who can do this), decreasing on social contact and avoiding crowded spaces.

General advice for pregnant women to assist ensure a healthy pregnancy and nearly as good immunity as possible is to stay to a decent diet rich in iron (dark green leafy vegetables, fish and eggs) and pteroylglutamic acid (beans, pulses and green, leafy vegetables). A daily, pregnancy-specific multivitamin tablet may help.

Can I pass coronavirus to my baby?
A question i'm constantly being asked by my patients and their families is whether or not a pregnant woman who contracts COVID-19 could pass it on to her developing baby.

There are, indeed, many viral, bacterial and fungal infections that may be passed on to the baby during pregnancy, like chickenpox, rubella, toxoplasmosis, hepatitis and HIV.

However this can be not the case for all viruses - some do get passed on, some don't.

There is currently no evidence to suggest that coronavirus may be passed to an unborn baby if the mother is infected.

A study published within the Lancet, the independent medical journal, which followed nine pregnant women who had tested positive for COVID-19 in China, found that none of their babies tested positive for the virus at birth (it is worth noting all the babies were born via caesarean section). Although these numbers are small, they're promising.

There was also no evidence of the virus being present in these women's humour - that's the fluid that surrounds and cushions the baby during pregnancy - additionally as no evidence found in blood samples taken from the fetal membrane of every of the babies. this may suggest that a standard, vaginal delivery is safe, but we cannot yet provides a definitive answer about this because the numbers within the studies to this point are so small.

All of this may suggest there's little evidence of babies contracting the virus from their mothers during the pregnancy.

Can I pass it on by breastfeeding?
It is less clear when it involves breastmilk, however; we still cannot draw any real conclusions about whether or not breastmilk may carry the virus.

Some viruses, like HIV or cytomegalovirus (CMV), are known to be transmitted in breastmilk but, so far, there's no evidence that COVID-19 itself may be.

The advice because it currently stands is for mothers who are freed from the virus to continue breastfeeding their babies but to confirm good handwashing before the feed.

If the mother develops a temperature or cough, then she should think about employing a breast pump to specific her milk and allowing someone who is well to feed her baby until she feels better.

There is many evidence that breast milk is sweet for your baby's system and stopping it altogether may make them more liable to the virus.

As time goes on and, inevitably, more pregnant women do contract the virus, we are going to know more about how the virus behaves, except for now taking sensible precautions - handwashing, social distancing, staying reception, not having visitors - is that the top course of action.

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