When a mother is seriously infected with Covid-19 during childbirth, how should the newborn baby be cared for?

In the context of translation Covid-19 still have many impacts on life, in addition to protecting at-risk groups and young children, pregnant women are also subjects that need special attention. At the 2022 Obstetrics – Pediatrics seminar, the issue of caring for pregnant women infected with SARS-CoV-2 during and after birth was discussed.

When is the right time for a mother infected with Covid-19 to give birth?

According to MSc Lam Le Dieu Hang, Department of Obstetrics and Gynecology, Hoan My Thu Duc Hospital (HCMC), pregnant women who are admitted to the hospital need to be tested for Covid-19 screening according to current regulations. Screening for potential diseases such as pre-eclampsia, heart disease, pulmonary embolism… should be done at the same time as influenza.

If indicated, pregnant women should be tested for other infections such as respiratory syncytial virus, mycoplasma, pneumococcal bacteria, etc. Blood cultures should be performed in patients with respiratory symptoms. below and fever.

During the time when a pregnant woman is suspected of being infected with Covid-19, it is necessary to give priority to medical treatment first, and to limit obstetric interventions, except for cases requiring emergency intervention (such as placenta previa, placenta previa bleeding, etc.). placental abruption, fetal distress,…) or subacute (break of membranes, labor,…), or when the mother shows signs of worsening. Doctor Hang noted that Covid-19 infection is not a reason to end a pregnancy, unless it is necessary to improve maternal oxygen.

Besides, choosing the time of birth is also a very important thing for pregnant women with Covid-19. With F0 women with mild symptoms (or no symptoms) at 39 weeks gestation, most of them do not have complicated disease progression. If the patient has an indication for termination of pregnancy, it should not be delayed if medical resources permit.

In the case of gestational age less than 39 weeks, without associated obstetric diseases, labor is ideally at the time after recovery. For women with comorbidities such as premature rupture of membranes, pre-eclampsia, gestational diabetes, the termination of pregnancy is according to obstetric instructions from the doctor.

How to take care of children when the mother is still F0

After the baby is born, medical staff should immediately perform essential care for mothers and babies. Specifically, consider skin-to-skin contact, one-stage delayed cord clamping, and breastfeeding support for the first 90 minutes. Children may be accommodated in the same room day and night if their condition health mother allows.

In particular, it is necessary to prevent the spread of the virus to children during close contact with measures such as: washing hands before holding, feeding or pumping milk, avoiding coughing and sneezing when breastfeeding. Wear a mask when breastfeeding, change the mask when it gets wet, and dispose of trash in a covered trash can.

In case a pregnant woman is severely infected with Covid-19 and cannot take care of the child, a separate room should be arranged for the child. A loved one or healthcare worker is responsible for the care of the baby and supports the mother to provide milk in the safest, most readily available manner. As soon as the mother is stable, the baby should be housed with the mother and breastfed as soon as possible.

The doctor added that babies born to mothers infected or suspected of being infected with Covid-19 need a process of 4 tests to assess their condition. The first test is from 2-24 hours after birth, the second time after 48 hours, and the third and fourth times at 7 and 14 days old.

The care and treatment regimen for the child depends on the clinical signs and is assessed and decided by the neonatologist. If no symptoms or mild symptoms, monitor vital signs every 4-6 hours. When there are signs of respiratory failure, monitor the monitor continuously, consider the use of antibiotics. Continuous dialysis may be considered if the baby has septic shock, multi-organ failure.

From the maternal perspective, it is necessary to advise the mother about post-Covid-19 symptoms and the duration of symptoms, including psychological disorders. All pregnant women should be screened for depression at 4-8 weeks postpartum.

Doctor Hang concluded that, after giving birth, the mother infected with Covid-19 and the child could live together or separate depending on the case. Evaluation and monitoring of respiratory function and general condition of COVID-19 patients in labor is essential, and caution should be exercised when considering obstetric conditions associated with or associated with other infections. .