Is it suitable for pregnancy during the epidemic?What should I do if I am infected after pregnancy?

On February 6, it is reported that a newborn woman with a new type of coronary virus (2019-NCOV) pneumonia is detected infected with 2019-NCOV within 36 hours after birthThe questioning of infection in the palace has caused the outside world to pay attention to whether the virus may have vertical transmission.What’s more, rumors such as "fetal patients with new crown pneumonia can not be needed" online.

The pathway of maternal and infants can be transmitted to the fetus through the mother’s placenta, or the pathogens in the mother blood can also get sick through the baby’s damaged skin and mucous membranes during childbirth.When it comes to the above cases, in fact, the details of many important clinical information of this case are not detailed, and the possibility of the newborn cannot be infected through respiratory tract infection after birth.There are also reports without coronary virus (including SARS and MERS viruses).It is not possible to conclude whether the infection can occur from this single case.Therefore, there is no evidence to support the possibility of maternal and infant transmission in 2019-NCOV.

In view of the following reasons, it is not suitable for pregnancy during the epidemic.

First, the crowd is generally susceptible to 2019-NCOV, especially pregnant women.Pregnant women were the susceptible people of respiratory pathogen. After pregnancy, the hormone in the pregnant woman will change significantly, which is affected by the increased estrogen. The respiratory mucosa will significantly increase the congestion and edema, which can easily lead to respiratory infections.Relatively inhibitory state; and with the development of pregnancy, pregnant women will have a series of physiological changes in other systems. Once the infection is more likely to develop into severe illnesses, making pregnant women face higher risks.

The second is the risk of being damaged by the 2019-NCOV infection.This is due to the fever and breathing difficulties caused by the new crown pneumonia, the blood oxygen content is reduced, and even other organs’ function may also be damaged.Therefore, the risk of miscarriage, premature birth, internal distress in the fetus, and the risk of dead fetuses will increase.Although there is no evidence to determine the direct impact of 2019-NCOV on the fetus, on February 6, 2020, a communications entitled "2019-NCOV Epidemic: What about Pregnancies?"Analyze the risk of pregnant women and fetuses under the raging epidemic and make relevant suggestions.From 2002 to 2003, 12 pregnant women were infected with SARS virus, of which 4 of the 7 pregnant women in the early pregnancy were aborted.Two of the five women in the middle and late pregnancy have limited growth, 4 premature births (1 natural childbirth, 3 oxyticism).Three women died during pregnancy.A review and analysis of 11 pregnant women infected with MERS viruses. 10 bad endings appeared. Six newborn need to enter the intensive care unit and 3 pregnant women died.Two newborns have prematurely produced because of severe respiratory failure.Considering that the 2019-NCOV seems to have similar path potential to SARS virus and MERS virus, 2019-NCOV may cause severe endless ending of pregnant women or fetuses, or both.

The third is that the treatment of new crown pneumonia itself may also have a certain impact on the fetus.Including antiviral drugs, antibiotics, and hormone therapy.

Fourth, during the epidemic, pregnant women’s nutrition, psychological factors, and exercise will have a certain impact, and therefore will also have a certain impact on the end of pregnancy.

The Suggestions for the "Expert Expert Expert Expert Expert Expert Expert Expert Expert Experts during pregnancy and puerperium" released on February 4, 2020 pointed out: 2019-NCOV is infected with pregnant women, and it should be treated in a centralized treatment according to the medical administrative department and inform them of the risk of bad pregnancy ending.

First, the end of the 2019-NCOV infection in the third trimester has no obvious bad ending.

"Liu Ye Dao" published a small sample research on the 2019-NCOV sample on the merger of 2019-NCOV on February 12.The author retrospectively analyzed 9 cases of maternal epidemiological characteristics, clinical manifestations, multiple laboratories and imaging of pregnant women from January to January 31st in the Central South Hospital of Wuhan University from January 20th to January 31st.Examination results, maternal complications and pregnancy endings.The study reminds that the clinical characteristics of patients with 2019-NCOV patients are similar to non-pregnancy adult patients. None of the nine patients progressed during observation as severe pneumonia or death.At the same time, the author also mentioned that, in view of the small number of cases, all patients in the third trimester, and the treatment is very timely, the 2019-NCOV infection has no conclusion on the ending of the pregnant woman itself.In addition, the nine newborn were lively, and no newborns were suffocated or born infected.Therefore, there is no evidence that the 2019-NCOV infection can lead to the ending of serious bad newborns, and there is no evidence that the 2019-NCOV can cause maternal and infants to spread vertically.However, after the birth of the newborn, it should be isolated for at least 14 days. During this period, it is not recommended for direct breastfeeding.It is recommended that the mother squeeze out the milk regularly to ensure lactation, and it can not be feeded until it is excluded or cured.

The second is whether the pregnancy is terminated in the early and in the early pregnancy?

At present, there are few cases of reporting reports on the end of the 2019-NCOV infection on the end of pregnancy, and most of them are in the third trimester. Although pregnant women also experience anti-2019-NCOV infection, the fetus is in a low-sensitivity period for antiviral drugs.Therefore, there is no sufficient evidence to show whether the patient’s condition worsen after the 2019-NCOV infection; there is no sufficient evidence to show that the risk of maternal dissemination in 2019-NCOV is not enough;Essence

If infection in the early pregnancy, severe clinical symptoms such as continuous high fever, and the treatment of confrontation infection itself may have a certain impact on the embryo, it should attract particular attention.

Although the 2019-NCOV may have various effects on pregnant women and fetuses, this does not mean that pregnant women end pregnancy once they find infections.Once pregnant women are infected with 2019-NCOV, they should be diagnosed multi-subject. According to the gestational week, fetal development, severity of the disease, the wishes of the pregnant woman and their families, they will comprehensively consider whether to continue pregnancy.

In short, currently lacks data on the ending of the 2019-NCOV infection, it is recommended that any pregnant women who are suspected of 2019-NCOV infection should be conducted systematically.The confirmed case should be closely followed up for the mother and the fetus.

Author: Liu Zhaofen, researcher at the Chinese Prevention Medical Association; post -doctoral obstetrics and gynecology; Science and Technology/Popular Science Experts of China Science and Technology Publishing House.Wang Linhong, Chairman of the Maternal and Child Health Branch of the Chinese Prevention Medical Association

references:

1. Wang Yunhui, Zhang Rui, Zhang Jianping, etc. The effects of SARS infection on pregnancy ending, fetal and babies.

2. Zhang Jianping, Wang Yunhui, Chen Leining, etc., etc. The clinical analysis of the acute respiratory syndrome in the middle and late pregnancy.

3. Huijun Chen, PHD, Juanjun Guo, MS Chen Wang, PHD; Et Al .clinical Characterturals and Intrauterine Vertering Potential of Covid -9 Infection In N INE Pregnant WOMEN: A Retrospective Review of Medical Records. Published: February 12,2020 doi: http://doi.org/10.1016/s0140-6736 (20) 30360-3

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