IMR Press / CEOG / Volume 50 / Issue 3 / DOI: 10.31083/j.ceog5003051
Open Access Systematic Review
Perinatal Care during the COVID-19 Pandemic
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1 Department of Education and Research, National Taiwan University Hospital, 100 Taipei, Taiwan
2 School of Medicine, College of Medicine, Fu Jen Catholic University, 242 Taipei, Taiwan
3 Department of Nursing, Taipei City Hospital, 10341 Taipei, Taiwan
4 Department of Nurse-Midwifery and Women Health, National Taipei University of Nursing and Health Sciences, 11220 Taipei, Taiwan
5 Department of Medical Research, Tri-Service General Hospital, 11490 Taipei, Taiwan
6 Department of Obstetrics/Gynecology, Taipei City Hospital, Zhongxiao Branch, 115 Taipei, Taiwan
7 Department of Education and Research, Taipei City Hospital, 106 Taipei, Taiwan
8 Department of Health and Welfare, University of Taipei, 115 Taipei, Taiwan
9 Department of Pediatrics, Taipei City Hospital, Zhongxiao Branch, 115 Taipei, Taiwan
*Correspondence: DXO90@tpech.gov.tw (Chih-Chien Cheng)
Clin. Exp. Obstet. Gynecol. 2023, 50(3), 51; https://doi.org/10.31083/j.ceog5003051
Submitted: 25 November 2022 | Revised: 13 January 2023 | Accepted: 19 January 2023 | Published: 10 March 2023
(This article belongs to the Special Issue COVID-19 in Pregnancy)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Following the pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and considering its capacity for rapid mutation, there have been many studies and articles on this novel coronavirus over the past three years. Therefore, providing knowledge and directions for management of SARS-CoV-2, for hospital staff is crucial. Hence, we collected the research information from different perspectives and summarized the guidelines for perinatal care on the topic of SARS-CoV-2, and for possible future viral pandemics. Methods: A systematic review aimed at assessing the publications written in English and Chinese, offering different perspectives on the topic of perinatal care concerning SARS-CoV-2, was conducted using PubMed and Google Scholar from 2020 to 2022. In addition, we summarized the guidelines from the Taiwan Association of Obstetrics and Gynecology, American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine, Maternal Immunization Task Force and Partners, and Academy of Breastfeeding Medicine. Results: Due to physiological changes, pregnant patients may be prone to have complications, especially pre-eclampsia, affecting morbidity and mortality. Most neonates of coronavirus disease (COVID-19) infected mothers did not show any clinical abnormalities due to the infection. However, compared to the general population, infected neonates needed more invasive ventilation care, while the proportion of asymptomatic neonates was less than that in the general population. Further, long term complications are still under investigation. Evidence of vertical transmission via the placenta and umbilical cord is rare but not absent. Paxlovid (nirmatrelvir/ritonavir) can be administered to patients with comorbidities, and indications for cesarean delivery does not include COVID-19 infection. Vaccination against COVID-19 should not be delayed during pregnancy and lactation. Conclusions: Obstetricians and gynecologists should pay more attention to pregnant women with SARS-CoV-2 because of the physiological changes and higher risks of complications, morbidity, and mortality. Early prevention with vaccination in pregnant women is the key to controlling the COVID-19 pandemic, from which we can learn how to manage the next pandemic.

Keywords
SARS-CoV-2
pregnancy
COVID-19
prenatal care
postpartum
pandemic
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