Coronavirus Disease 2019 in Pregnancy: A Clinical Management Protocol and Considerations for Practice

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has represented a major impact to health systems and societies worldwide. The generation of knowledge about the disease has occurred almost as fast as its global expansion. The mother and fetus do not seem to be at particularly high risk. Nevertheless, obstetrics and maternal-fetal medicine practice have suffered profound changes to adapt to the pandemic. In addition, there are aspects specific to COVID-19 and gestation that should be known by specialists in order to correctly diagnose the disease, classify the severity, distinguish specific signs of COVID-19 from those of obstetric complications, and take the most appropriate management decisions. In this review we present in a highly concise manner an evidence-based protocol for the management of COVID-19 in pregnancy. We briefly contemplate all relevant aspects that we believe a specialist in obstetrics and maternal medicine should know, ranging from basic concepts about the disease and protection measures in the obstetric setting to more specific aspects related to maternal-fetal management and childbirth.

Keywords: Coronavirus; Coronavirus disease 2019; Delivery; Pregnancy management; SARS-CoV-2.

Fig. 1

Summarized management of CO­VID-19 during pregnancy. COVID-19, coronavirus disease 2019; CPAP, continuous positive airway pressure; CTG, cardiotocography; LMWH, low-molecular-weight heparin; SO₂, oxygen saturation.