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CORONAVIRUS: PART 2

Hello again to all my readers.  By now, most of you are social distancing and working from home.  Many of you are trying to do this and take care of children who are out of school or daycare.  While burdensome to everyone, this quarantining is for the betterment of society and will save lives if as many who can do it, actually do it.  We can only hope for the quickest possible control of Coronavirus so that we return to our “normal” lives. As a reminder, we ask that you come alone to all prenatal visits including sonograms.  You can facetime/skype whenever necessary. We want to greatly limit the number of bodies coming in and out of the office. This is for your safety, the safety of other pregnant women, and for our safety so that you have all of us available to continue caring for you during your pregnancy.

This blog will share the most recent information that was distributed to us by the Society for Maternal Fetal Medicine (these are the high-risk pregnancy experts).  My goal is to explain the information in an easy to understand way. 

  • Coronavirus is spread from an infected person (who may or may not have symptoms) through airborne droplets from sneezing or coughing, close personal contact (such as shaking hands or a nearby surface that contains virus then touching your nose or mouth before washing your hands).  It is currently unknown if the virus can spread through sexual intercourse or semen.
  • There is still very limited data on pregnancy and Cornavirus. Currently only a couple of studies reviewed 18 cases.  Only 1 patient required ICU care for respiratory distress. However, the pregnant mom is known to be more susceptible to getting sick from respiratory viruses (like influenza) than a nonpregnant woman.  
  • There is not enough data on Coronavirus and the risk of miscarriage or fetal anamolies if an infection were to happen in the earlier months of pregnancy.  If we extrapolate data from the SARS epidemic there did not seem to be an increased risk of fetal loss or anomalies.
  • Testing guidelines seem to change daily.  Please consult recommendations from the CDC if you think you need to be tested.  Remember, we do not have the ability to test you in the office. PLEASE PLEASE PLEASE do not come to the office if ill.  You are exposing other patients and then our staff and providers who can expose other patients. Testing centers (many drive thru) are being set up.  If for some reason a medical provider thinks it is in your best interest to do a CT scan of your lungs, please allow them to do it and just have them shield your abdomen with lead.  The amount of radiation with this precaution should be safe.
  • As mentioned in my previous blog, there is no evidence that Coronavirus is found in the amniotic fluid or umbilical cord blood of infected mothers.  This is reassuring that transmission is not through the placenta to the baby.  
  • Any extreme viral illness can cause preterm labor or lower birth weight.  Because of this, if we have patients who are known to have had a Coronavirus infection during their pregnancy, we will be doing third trimester sonography to better assess fetal growth.  Preterm labor symptoms will be managed on a case by case basis.  
  • Timing of delivery, inductions or c-sections should not be affected by Coronavirus infections.  It is even reasonable to delay delivery/induction/c-section until patients recover from the virus.  The mode of delivery is also not affected and should be dictated by normal obstetrical parameters.
  • If you deliver a baby while you have Coronavirus, the CDC currently recommends temporary separation (different rooms) for you and your baby until transmission precautions are stopped.
  • Coronavirus is not excreted in breast milk and thus breastfeeding is still encouraged.  If you are in the above separated situation, then using pumped or expressed milk is ideal with thorough cleaning of the pump and attachments after each session.  In scenarios where the infected mother and her infant are not separated, using a mask and thorough, frequent hand washing is recommended. 
  • Currently there is no antiviral treatment or vaccine.  Social distancing as much as humanly possible is the best thing you can do right now.
  • We may offer the lowest risk patients some spaced out visits, especially early in pregnancy, to allow you to stay home.  This recommendation will be made on an individual basis.  
  • WakeMed (consistent with other labor units in town) allows only one support person with each patient.  Other family members cannot even be in the waiting room.

I will post new blog(s) as more information is released.  Thanks for social distancing. Stay safe!

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Two Locations

Computer Drive Office
3805 Computer Drive
Raleigh, NC 27609
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Durant Medical Center
10880 Durant Road, Suite 224
Raleigh, NC 2761
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Wake Med - Main Campus