While over 380 pregnant women have tested positive for the novel coronavirus in the district so far, most of them were asymptomatic, though they remain at high risk, according to health officials.
So far, 387 pregnant women have tested positive for SARS-CoV-2 in the district. Of them, around 180 cases are still active, and the others have recovered, said Dr. Sivadas M. G., Reproductive and Child Health Officer. Most pregnant women have been asymptomatic, he pointed out. Two deaths of COVID-19 positive pregnant women were reported in the district and both were attributed to pneumonia, he said. “Since their immunity is low, chances are high that the virus might replicate more vociferously, and lead to a more severe form of the infection in some cases,” he said.
A 29-year-old from Thiruvananthapuram was in the fifth month of her pregnancy when she tested positive for the virus in Ernakulam in July. She was admitted to the Government Medical College Hospital and spent 23 days, including a few in the ICU, recovering. “Her oxygen saturation levels were low and her condition was complicated by an existing heart condition. She delivered a healthy baby a few days ago,” her husband said. They suspect that both of them had contracted the infection from another hospital in Thiruvananthapuram that they had visited for a check-up, he said.
Susceptible to infections
Immunologically, pregnant women are susceptible to infections, not just from the coronavirus, placing them at high risk, said Dr. Prathibha Chandrasekharan, gynaecologist at the Ernakulam General Hospital. The number of women seeking antenatal check-ups at the hospital had fallen to about one-third of pre-COVID-19 figures, she said. But that does not mean that they were not getting their check-ups, she added. “It is possible that they chose to visit smaller clinics or health centres closer to their homes, rather than visit a crowded hospital. ASHA workers have also consistently been monitoring the health of pregnant women in their areas,” she said. Women who visit the hospital have been asked to wear masks inside their homes and strictly follow physical distancing and hand hygiene protocol, she said.
A first-line treatment centre for pregnant women was set up on the SCMS College premises at Muttom. Most women choose to remain at home now, but the 80-bed FLTC is available for women who might not have the facilities to remain in isolation at home, Dr. Sivadas said. Around 45 beds at the FLTC are occupied. If they develop symptoms, they are immediately transferred to the MCH, he added.
In the early phase of the pandemic, complications in pregnant women were few, but now more women were reporting complications including pneumonia, said Dr. Shobha Pillai, gynaecologist and associate professor at the MCH.
A challenge
Dr. A. Fathahudeen, nodal officer for COVID-19 treatment at the MCH, said that they had seen about three severe cases of the infection in pregnant women.
The impact of antivirals like remdesivir on the foetus was not yet clear and such medication, which is given to seriously ill COVID patients, is usually avoided while treating pregnant women, he said. In a more recent case at the hospital, a woman in an advanced stage of pregnancy and with very low oxygen saturation was delivered of a healthy baby via C-section to give her a better shot at fighting the disease with the antivirals, he said.
In women who are in the early stages of pregnancy, CT-scans and X-ray imaging are usually avoided, which is another challenge while treating pregnant women with COVID, he said.
