Suspected or confirmed infection in pregnant women
Routine appointments for women with suspected or confirmed COVID-19 (growth scans, oral glucose tolerance test, antenatal community or secondary care appointments) should be delayed until after the recommended period of self-isolation.
If it is deemed that obstetric or midwifery care cannot be delayed until after the recommended period of isolation, infection prevention and control measures should be arranged locally to facilitate care. These appointments/scans should preferably be arranged at the end of the working day, to minimise exposure to other pregnant women.
Referral to antenatal ultrasound services for fetal growth surveillance is recommended ten days after resolution of acute illness. Although there is not yet evidence that fetal growth restriction is a risk of COVID-19, two-thirds of pregnancies with SARS were affected by FGR and a placental abruption occurred in a MERS case, so ultrasound follow-up seems prudent.
There is no evidence to suggest that steroids for fetal lung maturation, when they would usually be offered, cause any harm in the context of COVID-19. Steroids should therefore be given where indicated.
In the event of a pregnant woman attending with an obstetric emergency and being suspected or confirmed to have COVID-19, maternity staff must first follow IPC guidance. This includes transferring to an isolation room and donning appropriate PPE. This can be time-consuming and stressful for both patients and health professionals. Once IPC measures are in place, the obstetric emergency should be dealt with as the priority. Do not delay obstetric management in order to test for COVID-19.