COVID 19 in Pregnancy, Vaccination in Pregnancy

COVID 19 in Pregnancy, Vaccination in Pregnancy, Lactation and During Menstruation

As we tread ourselves through the second wave of the Covid 19 pandemic and vaccination being the present day hot topic, I have tried to answer few queries posed by our patients, pregnant women and their families. This is based on our clinical experience combined with the knowledge and facts from various authentic professional medical organizations.

Question: Is this second wave different?

Answer: The virus seems to mutate and new strains are coming up. So the severity of the infection also changes. We are trying to understand its origin, transmission, mutation, epidemiology and immunology. The infectivity is really high and its important to seek help at the earliest to avoid any complication.

Question: Are pregnant women more at risk?

Answer: Yes, pregnant women are slightly at a higher risk of getting infected.

Question: What are the reasons for increased risk?

Answer: Pregnancy is a slightly immunocompromised state, and some women can have complications in pregnancy like increase age, diabetes, Obesity, blood pressure, multiple pregnancy posing them a higher risk than the general population. There is also increased tendency to form clots in pregnancy due to changes in the coagulation system which can be aggravated by COVID infection.

Question: Can I have routine pregnancy check-up?

Answer: You can discuss with your doctor regarding reducing the number of visits and doing tele consultations as and when needed. All the important scans and blood tests need be done as usual at stipulated time taking all covid precautions.

Question: Where to Deliver if I test covid positive before delivery? Are attenders allowed to stay with me?

Answer: It is important to discuss with your doctor regarding delivery place and time in case the predelivery COVID report comes positive. Some women can deliver preterm (before 37 weeks if they have had covid infection in the past).

PLEASE DO NOT PANIC. Your doctor will guide you and deliver in COVID designated hospitals. As of now, we don’t allow attenders with covid positive patients, but our team of doctors and nursing staff will help with your quick recovery and breast feeding.

Question: Can I Breastfeed if I am tested covid positive?

Answer: All asymptomatic covid positive delivered women can breast feed their babies with all the usual hygiene precautions like hand sanitizing and wearing a mask. If they have mild symptoms, they can express the milk and another family member can give expressed milk to the baby.

Question: Can I get Vaccinated during pregnancy and lactation?

Answer: Even though foreign countries like USA, UK have started vaccinating pregnant and lactating women, we are yet to get the approval from ICMR (Indian Council for Medical Research). It is very difficult to do trials on pregnant women due to ethical concerns, but we shall update you once we have clear guidelines regarding the type of vaccine, dose, dosing interval, and timing (at how many weeks of pregnancy). Women can make informed choice about vaccination in pregnancy and lactation after discussing with their doctors. (FOGSI statement April 2021- Women should be counseled and empowered to make their own decision supported by caregivers.)

Question: Can women get vaccinated during menstruation?

Answer: Absolutely. The vaccine can be taken during menstruation. There are lots of social media posts doing rounds that vaccine should not be taken during menstruation. Those are false and the vaccine can be taken on any day of the cycle, even during menstruation.

Question: Can I take the vaccine when I am planning pregnancy or undergoing fertility treatment?

Answer: Women should take the vaccine at any point of time before a pregnancy is confirmed as and when they have an opportunity to do so. There is no basis for deferring pregnancy or treatments for taking the vaccine. There is no evidence that vaccine administration affects fertility or miscarriage rates.

Question: Should I do pregnancy test before taking the vaccine?

Answer: This is not necessary and creates a hurdle to vaccine acceptance. It is not recommended to test for pregnancy before vaccination.

AND finally… PREVENTION IS BETTER THAN CURE

The way forward- MASK, HYGIENE, SOCIAL DISTANCING and THE VACCINE.

ICMR- Indian Council for Medical Research
FOGSI- Federation of Obstetric and Gynaecological Societies of India