COVID-19 and Pregnancy in Dubai

We sat with Dr Amelie Hofmann-Werther, a German Board certified specialist obstetrics and gynecology, practicing in Dubai, to clear up some doubts and offer some guidance for pregnant women during the COVID-19 pandemic. We rounded up some commonly asked questions from women living in Dubai and got on a call with Dr Amelie to ask for her expertise:

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Dr. Amelie Hofmann-Werther

Specialist Obstetrics & Gynecology, Psychosomatics & Verbal Intervention Counselor, Cervical Dysplasia Colposcopist
Novomed Surgical Hospital

I am pregnant. How can I protect myself against COVID-19?

We do have quite a lot of women that are currently pregnant and facing a lot of anxieties and concerns due to the evolving pandemic of course. Generally spoken first thing may be which should be reassuring that women in pregnancy, they are not in general more at risk to catch Covid virus. So the same hygiene precautions apply to pregnant women of course. Best thing to protect themselves is proper hand hygiene, which including as we know already, washing our hands frequently and using alcohol based hand rubs for enough time and letting them air dry a minimum for 30 seconds and then of course and again keeping space between you and others, practicing respiratory hygiene when sneezing and coughing. So it is exactly the same and also of course staying at home as much as you can and having very little interactions with other people.

If I tested positive for COVID-19, can it pass through the placenta or birth canal to my baby?

There are currently a lot of researches done on the question, but as general recommendations for what we know as of now is that we have no evidence that this virus can be passed on from the mother to the baby through the placenta, or through umbilical cord blood. There is no such data but of course; those cases that are currently under review once again the numbers of cases we can study are still small. The World Health Organization and a lot of other colleges at the moment are really reassuringly saying there is so far no need to worry that you could pass on the virus to your baby when the baby still in the womb and I think that's that's something the majority of the women should always keep in mind.

How do I distinguish between a fever related to my pregnancy or to COVID-19?

The symptoms to look out for is basically persistent or recurrent fever attacks that are higher than 37.8 degree Celsius plus additional symptoms such as cough, as sneezing, as sore throat so the majority of women that would face such symptoms should sort of have a look if they persist if they come back if they are accompanied with such other symptoms.

Do pregnant women with suspected or confirmed COVID-19 need to give birth by caesarean section?

From the data that we have which published by the most important colleges such as the CDC, also the World Health organization and in our case the world college of Obstetrics and gynecology of American college there is so far no, there is no recommendations that a woman due to the fact that she was tested positively should deliver by the mode of delivery of the cesarean section. Of course going through labor is a process where the heart beat goes up of the mother and there are stress hormones involved. It's a process where the maternal body will need to utilize a lot of oxygen and if for some reason a woman is not only tested positive but shows symptoms and it looks like oxygenation isn't ideal, it would show in the baby's heart rate monitoring as well. And then it decision could be taken to either speed things up, shorten the time of delivery by instrumental assisted delivery or ofcourse the mother isn't doing well and the baby is not coping well then decision could be taken to proceed with the cesarean section but in general decision to take everybody who is giving to deliver in next weeks should you know book a cesarean section, thankfully is not given.

What are the mandatory visits for pregnant women taking into account required permits and restrictions during COVID-19?

In general, I would like to outline that I am a great advocate of offering antenatal care for women. Looking into the entire pregnancy caretaking that does not only mean face to face appointments with the doctors for certain examinations but also support you know for everything that goes along with the covid which a pandemic anxiety, stress, depression, sleep deprivation, loss of appetite may be increased headaches or nausea because of the price comes along with the situation. They should have the opportunity to do a lot of meetings as we do it now, online consultations, which is basically question and answer, so they might not need to see the Doctor face to face for the things they have, the concerns they have. When it comes to visits that we consider crucial for the pregnancy, I usually, I would personally recommend that women attend a 10 week scan which is a viability ultrasound and a datingscan, is it one baby or two or three. Is the baby located in the position where it should be and not ectopic? Today how far along is the pregnancy? As per my personal recommendation, I would personally stick absolutely to the first trimester ultrasound with the nuchal translucency that what is usually referred to as though 12th week scan or first trimester screening and then of course prioritise the organ scan or morphology scan which is usually between 18-19 to 21 weeks and then later on cross scan to assure that the baby has a positive growth.

Can my birth partner be present during the birth?

Yes! That's absolutely possible. We actually encourage that the husband or the birth partner whoever that maybe, the closest friend, the mother, is attending for mental support and guidance really needs a birth companion in particular in these times when there is a lot of anxiety and fear coming along with those exciting moments. We do of course recommend that the birth companion is not currently tested positive or is showing symptoms that are pointing towards a COVID infection. So, we do not recommend a person under investigation to attend. In this case, it should be communicated in advance to the maternity unit and maybe an alternative birth companion can be found just for the safety of the mother and baby. Some colleges have guidelines such as the CDC, they recommend not wearing any watches or jewellery because they can not be kept clean according to the hygiene advice and some do recommend that the husbands do not have long beard when attending because it could potentially also be a hygiene problem. But apart from that, yes, absolutely no woman has to be alone in labour!

Can I breastfeed my baby if I am COVID-19 positive?

Here again, the majority of the guidelines that we know, America, UK, Asia, Europe. They are saying yes you can breastfeed. And this recommendation is currently given on the basis that we do not have any evidence so far of virus being transmitted through breast milk. So we would not find virus detection in breast milk. Of course there is a certain risk always going along with the fact that breastfeeding requires close contact to the baby. It is a skin to skin contact and of course the mother is close to the baby. It might sound trivial to say try not to cough or sneeze to your baby, wear a mask and proper hand hygiene. It is a very sensitive topic and I have read from certain colleges and certain guidelines that they do actually think or consider and discuss separation of mother and baby after birth, if the mother was tested positive and shows symptoms, to save the baby. That would mean the baby is either really separated in a different room or maybe 2 metres 6 inches between mummy and baby bed or curtain separating the room. This is of course something that has to be a topic that has to be approached very sensitively because it is crucial for the bonding in the earliest hours after delivery that mommy and baby are allowed to have skin to skin contact and if a woman is intermittently breastfeeding and pumping alternately. The milk that has been pumped could also be fed by a non-infected family member, the daddy, you know, the grandmother to space out close skin to skin or close bodily contact between mommy and baby. Still, I understand this is a sensitive topic, it must be heartbreaking where moms and babies have to be separated. As long as there is no direct transmission through the breast milk. There is no general no but of course, it requires discipline and it requires strict hygiene measurements. So the entire family needs to adhere to that of course!

*Disclaimer: Please consider the information in this video/article most recent as per date and medical recommendations towards COVID-19 may change as the situation evolves.