published For the European and the American society for reproductive medicine (European Society of Human Reproduction and Embryology, in short: ESHRE and the American Society for Reproductive Medicine, in short: ASRM) in mid-March due to the Corona pandemic, the recommendation is to stop all fertility treatments or to start any new treatments, and more, are insecure a lot of women and couples wishing to have children.
A majority of the planned IVF treatments (op. d. Red.: IVF stands for In vitro fertilization; i.e., artificial insemination) no longer or only to a very limited extent is currently being carried out. Justification of the recommendation, among other things, with the novelty of the Virus and the lack of clarity, what is the impact of the Coronavirus in pregnancy on both mother and child.
at the same time, the professional societies of obstetrics pregnant patients calm down. Therefore, many pregnant women and women with children desire issues now: As a Covid-19 infection is in the pregnancy? What is the impact of an infection on the Baby? About the author
Corinna man is a doctor of obstetrics and gynecology. After her medical studies in Munich and Harvard, she was in a different desired number of children centres. Since 2019, they met couples in your own practice, the desire to have a Baby.
This is what we know so far about the impact of the Virus
it is Known that the Virus is the most people – around 85 percent – are mild. Then the infection like a common cold manifests itself. Approximately 30 per cent, the infection is even without symptoms.
at the same time 15 percent of those Affected suffer a severe course of the disease. An average of five per cent of the Infected need to be cared for on the intensive care unit and depending on the country, to die is between 0.2 and five percent of the Infected to the Virus-induced disease Covid-19. So it is in the current WHO Report.
As the Sars-CoV-2 Virus is still very new – the first cases occurred in December 2019, our knowledge is still very limited to the course of infection in pregnancy and in particular, to the long-term effects on the unborn child. Also from earlier waves of Infection with other corona viruses such as Sars and Mers, there are only a few data.
How is infection with Sars-CoV-2 in pregnancy? There is an increased risk?
at the moment it is not yet known whether pregnant women have a higher risk than the General population to suffer severely from Sars-CoV-2. Overall, so far, there is internationally no indication that Pregnant women are particularly at risk. It is expected that the majority of healthy Pregnant women therefore experience only mild or moderate symptoms such as a cold or the flu.
at the same time it comes in the pregnancy changes in the body. Also, the immune system is changing and can make many pregnant women are more prone to an infection and also pneumonia. In addition, the volume of the lung in the later pregnancy, is reduced. So, it comes with a Influenza in pregnancy is often more severe gradients.
In the case of the coronaviruses Sars and Mers, the course of disease and complications were generally in the normal population, are more than the current Coronavirus infection. Pregnant patients had to be ventilated in the case of Sars, and Mers, however, three times as often as non-pregnant women. In the case of the current Sars-CoV-2 Virus, yet only around two percent of the pregnant women had to be ventilated. FOCUS Online provides you with the most exciting Reports from the parents. Here you can subscribe to the Newsletter.
Although severe cases occur primarily in the elderly or people with pre-existing conditions cannot be excluded, therefore, a more severe course of the Covid-19-disease in pregnancy.
If there is already prior to the pregnancy, a heart or lung disease is present, is to be expected with a more severe course of the infection. Pregnant women with a corresponding pre-existing conditions should be again much more cautious.
The mortality rate of pregnant patients with Sars amounted to 18 per cent, and in the case of Mers to 25 percent. In the case of infection with Sars-CoV-2 so far, died a pregnant woman.
In some recent scientific publications, for example, in the prestigious American Journal of Obstetrics and Gynecology is even speculated that hormonal changes during pregnancy may alter the immune responses against viruses and specifically against Sars-CoV-2 positive. As would be expected with milder gradients, a Coronavirus infection in Pregnant women to. Many fathers may not be present at birth: the doctor explains Corona-the delivery room-rules PCP, Many fathers may not be present at birth: the doctor explains Corona-the delivery room-rules
the risk for complications Is higher?
In the case of Sars and Mers, there was in early pregnancy at seven known infections to four miscarriages and more premature births. Neither Sars nor Mers Transmission of the infection to the Baby has been demonstrated.
so Far, infections the following complications have been described in the case of Coronavirus in pregnancy: two percent of the patients it came to abortion, a miscarriage, at ten percent, to intra-uterine growth retardation (IUGR), so a delay of growth, and 39 percent to preterm birth in the 3. Trimester of pregnancy. the
Will transfer the infection to the child?
currently, 55 pregnant women with Covid-19 and 46 of the newborn have been scientifically described, it was found no so-called vertical Transmission. So it has been no Transmission of infection from mother to child during pregnancy.
A new study is added at the end of March from China. It has examined 33 infants born of mothers who have had Covid-19,. In three out of the 33 neonates of the Coronavirus have been detected shortly after birth. Transmission of the infection in the womb can therefore not be excluded.
The symptoms in the newborns, however, were very mild. Only a Newborn child who was born circa nine weeks early, had breathing problems, but this is due rather to preterm birth as the Virus.
In all of the studies conducted so far is not a Virus in amniotic fluid was detected in umbilical cord blood, breast milk, or in the throat swab in the newborn, the Covid-19 ill mothers (Chen et al. 2020).
are So ill all the surveyed pregnant women in the third Trimester of Covid-19. Yet there is no obstetric data of pregnant women that are sick in the first Trimester. the
also read: Marion Kiechle in conversation – What is Corona for Pregnant women
means a malformation risk, or other risks to the unborn child?
In the previously reported cases, as described above, more frequent premature births. Of other viral infections of the respiratory tract such as Influenza, Sars or Mers, we know that they are often associated with risks for the newborn in combination. This includes a low birth weight and premature birth include.
Due to the novelty of the Virus are the effects of an infection at the beginning of the pregnancy in the first trimester, and possible malformations at birth is not yet known. So far, however, there are no indications of possible malformation. In the case of the pregnant women in the third trimester and no Transmission of the infection to the child was demonstrated in the mother’s womb. Corona-office hours: here you can Set your question to Covid-19
The number of Corona-ill people increases, the of the questions as well. FOCUS Online has therefore built up a network of experts and answer your questions.
The consultation
Needs to take place, the birth in the case of a Sars-CoV-2 infection by caesarean section?
The German society for gynecology and obstetrics (DGGG) says that there is no reason for childbirth via C-section in the case of a suspected Coronavirus infection.
a quick delivery If, however, due to respiratory complaints, or other reasons, a caesarean section is recommended of birth.
every Day, new studies appear, so that in the next few weeks and months, hopefully more and more additional responses to the effects of Coronavirus on pregnancy can be found. Infections Lodge gives the all-clear: “Many of the children are infected, but the course is mild” PCP infection Loge gives the all-clear: “Many of the children are infected, but the course is mild”
