Nana M, et al. Diagnosis and Management of COVID-19 in Pregnancy. BMJ 2022;377:e069739.

Dr. Karpagambal Sairam

Consultant Obstetrician, Gynaecologist and Fertility Specialist, Kauvery Hospital, Chennai, India

*Correspondence: karpagambal@hotmail.com

We know that COVID shook the entire medical fraternity and every specialty of medicine has borne the brunt of COVID infection. I am very glad that BMJ has published this excellent article which encompasses the complete spectrum of clinical features, laboratory investigations, diagnostic challenges in pregnancy and treatment protocols that differed from one unit to another as the risks to the fetus were also to be considered. COVID in pregnancy is a potential chapter for the Obstetric textbooks in the forthcoming years …

Pregnant women are definitely more susceptible as there is slightly less immunity in pregnancy. Fortunately, most of our women were young with fewer comorbidities like HT and DM, and fought the disease with ease.

Pregnant women are definitely more susceptible as there is slightly less immunity in pregnancy. Fortunately, most of our women were young with fewer comorbidities like HT and DM, and fought the disease with ease.

Having seen the entire spectrum of the disease, from mild to the very severe, in our patients I would like to highlight the non- clinical challenges faced by the women and the doctor as the paranoia was threatening mental health more than physical health.

What really moved the entire medical community was the way all our COVID positive women rose to the occasion and learned to take care of themselves, handle the new-born, and learn the art of feeding without much support (all hospitals were understaffed, lactation support nurses were not allowed or refused to come) as attenders were not allowed. A happy, and unique, experience of going through pregnancy, delivery and lactation that generally has so much support from friends and family, turned out to be a nightmare for many. Periodic communication and counselling played a very important role and all of us turned out to become counsellors as we felt the need for preventing psychological problems postpartum. I am sure these women and their babies would emerge stronger as they have faced the biggest ever challenge in their lifetime. The separation of the mother and baby, and not being able to feed, was the most stressful aspect as the natural process was disrupted as some mothers were sick in ICU; and also, the possibility of the risk of neonatal infection. The last two paragraphs of the paper, describing the maternal emotions when she held her baby after an ordeal in ICU (I would call this a REBIRTH from the clutches of death), are so touching that they brought tears to my eyes.

Overall, as an Obstetrician who has been delivering COVID-positive pregnant women ever since the pandemic emerged, it has been a great learning experience for me (having seen the best and worst of COVID) and I am more prepared to face any more pandemics. I feel every pandemic is nature’s wrath on exploitation of nature due to our complete lack of insight into coexistence.

Dr.-Karpagambal-Sairam-Venugopalan

Dr. Karpagambal Sairam Venugopalan

Obstetrician and Gynecologist

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