Institutions must ensure conditions to allow partners during childbirth

in News · 06-06-2020 12:00:00 · 0 Comments

Health units must ensure conditions to allow a companion in childbirth, as long as the pregnant woman is not infected with Covid-19, according to a new guidance from the Directorate-General for Health (DGS).

The document says that this companion cannot have had contact with infected people in the previous 14 days.

In the guidance, which updates previous information, DGS underlines that, "given the scarce scientific knowledge, decisions must be based on clinical assessment, the physical conditions and human resources of each institution and also the couple's choices".

"If the presence of companions cannot be guaranteed safely, exceptional measures to restrict companions can be considered, provided they are proportionate and based on the risk of infection by SARS-CoV-2", he says.

The DGS explains that, in the case of pregnant women with Covid-19, the restriction of the presence of a companion should be considered to reduce the spread of the infection “to people who may be involved in the care of the newborn within the family”.

When there is suspicion or confirmation of Covid-19, the DGS defines, among other measures, that labour is performed “with continuous cardiotocographic monitoring”.

"If there is no suspicion of infection, delivery should take place in the usual way, with the reinforcement of infection prevention and control measures and the use of appropriate personal protective equipment", he adds.

With regard to prenatal care, each institution may impose restrictions on the visitor policy “whenever the pregnant or puerperal woman is a confirmed or suspected case”, in order to limit the risk of disease transmission, the guidance says.

The document also establishes the procedures to be adopted during hospitalisation during pregnancy, namely the performance of a laboratory test for the new coronavirus, even if there are no symptoms suggestive of Covid-19.

In pregnant women diagnosed with Covid-19 under surveillance at home, face-to-face consultations and prenatal procedures should be postponed, whenever possible, as long as there is no compromise on clinical safety, until the isolation period at home ends, and teleconsultation should be privileged.

DGS says that, within the scope of Covid-19, one of the aspects that has raised the most doubts is the peripartum period, as well as the approach to pregnancy, mother and newborn.

"Scientific evolution requires a constant updating of the models of clinical approach, continuously adapted to the epidemiological evolution and the public health measures implemented", he stresses.

To date, “pregnant women do not appear to have an increased risk for covid-19, but immunological changes during pregnancy are known, as well as the possibility of unfavorable outcomes in infectious situations, especially in late pregnancy”, reminds DGS, stressing that scientific knowledge about infection during pregnancy "is scarce and based on a small number of cases".

It also reveals that there are three reports of antibodies detected in newborns, "which suggests a response to intrauterine infection", two cases of placental infection and even some reports of newborns with positive virus research in the first days of life, " which also raises the hypothesis of vertical transmission ”.

“This, if it occurs, will be in a limited number of cases and the data must be interpreted with caution. Some studies also suggest the possibility of prematurity, especially late, and the occurrence of horizontal transmission ”, informs the national health authority, remembering that, as the information is still scarce, all data must be interpreted with caution.


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