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SARS – CoV – 2 is a zoonotic coronavirus that crossed species to infect humans and caused a disease called COVID – 19. Despite the potentially higher risk of contracting SARS – CoV – 2 infection compared to the non-pregnant population , no additional specific recommendations are needed to avoid exposure during pregnancy. Fever, cough, lymphopenia, and elevated C-reactive protein levels are the most common clinical symptoms and laboratory signs of SARS – CoV – 2 infection during pregnancy. Pregnancy carries an increased risk of severe SARS – CoV – 2 infection compared to the nonpregnant population, including pneumonia, ICU admission, and death, primarily after adjusting for potential risk factors for severe outcomes. The risk of miscarriage does not appear to be increased in women with SARS – CoV – 2. The evidence is conflicting when it focuses on preterm birth and perinatal mortality, but these risks are generally higher only in hospitalized symptomatic women. The risk of vertical transmission, defined as transmission of SARS – CoV – 2 from the mother to the fetus or newborn, is generally low. Invasive fetal procedures are generally safe in women with SARS – CoV – 2 infection, although the evidence is still limited. Steroids should not be avoided if clinically indicated, preferring dexamethasone and then methylprednisolone for a total cycle of ten days. NSAIDs can be used if there are no other contraindications. Hospitalized pregnant women with a severe course of SARS-CoV-2 disease should undergo prophylactic thromboprophylaxis during the time of hospitalization and at least until discharge, preferably LMWH. Hospitalized women who have recovered from a period of severe or critical illness with COVID – 19 should be offered at least one fetal growth scan approximately 14 days after recovery from their illness. In asymptomatic or mildly symptomatic women who tested positive for SARS-CoV-2 infection at term (ie, ≥39 weeks’ gestation), induction of labor may be reasonable. To date, there is no clear consensus on the appropriate time of delivery for critically ill women. In women with few or no symptoms, treatment of labor should follow routine evidence-based guidelines. Regardless of COVID – 19, mothers and babies should stay together, breastfeed, practice skin-to-skin contact and kangaroo maternal care, and live together day and night while the necessary infection prevention and control measures are in place.
Due to the absence of long-term evidence-based data, the possibility of receiving the vaccine should be offered after extensive counseling on the potential risk of a serious course of the disease and the unknown risk of fetal exposure to the vaccine. .
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