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Covid-19: pregnant doctors should speak to occupational health, say experts

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1104 (Published 18 March 2020) Cite this as: BMJ 2020;368:m1104

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  1. Abi Rimmer
  1. The BMJ

All pregnant healthcare professionals, especially those who work in intensive care, have been advised to discuss their circumstances with their local occupational health department.

In recently published guidance the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, and the Royal College of Paediatrics and Child Health said that they had received a number of questions from concerned pregnant healthcare professionals.1

“We acknowledge the anxiety caused by the limitations of available information,” the guidance said. It added that, as far as was currently known, pregnant healthcare professionals were no more susceptible to the virus or its complications than their non-pregnant colleagues.

However, it warned that infection with coronavirus (covid-19) may pose some risks to a pregnant woman’s unborn baby. There is a possible risk of fetal growth restriction and a risk of premature birth if the mother becomes seriously unwell.

“We therefore advise all pregnant healthcare professionals, especially those in high risk areas [intensive care and high dependency units], to discuss their individual circumstances with their local Occupational Health department,” the guidance recommended.

Social distancing

Government guidance advises people with an increased risk of severe illness from covid-19, including pregnant women, to be particularly stringent in following social distancing measures. This means avoiding contact with others as much as possible.2

The royal colleges’ guidance said that the majority of pregnant women infected with covid-19 would experience only mild or moderate cold/flu-like symptoms. However, it said that more severe symptoms such as pneumonia and marked hypoxia could occur in pregnant women and should be identified and treated promptly.

“At present there is one reported case of a woman with covid-19 who required mechanical ventilation at 30 weeks’ gestation, following which she had an emergency caesarean section and made a good recovery,” the guidance said.

No data currently suggest an increased risk of miscarriage or early pregnancy loss in relation to covid-19, and case reports from early pregnancy studies of women with severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS) do not demonstrate a convincing relation between infection and increased risk of miscarriage or second trimester loss, the guidance said.

It explained, “As there is no evidence of intrauterine fetal infection with covid-19 it is therefore currently considered unlikely that there will be congenital effects of the virus on fetal development.”

References

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