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Question 15: What is the diagnosis and treatment protocol for pregnant women with COVID-19 at different gestational ages?
The decision-making principle of the diagnosis and treatment for pregnant women with COVlD-19: personalized assessment should be made, taking all factors into consideration including the gestational week, the severity of the COVlD-19, and indications for emergency obstetric care
(1) For pregnant women in the first and second trimester, the priority should be given to active treatment for COVlD-19 without considering termination of pregnancy for this stage.
(2) For pregnant women before 32-34 weeks of gestation with mild or ordinary infection, efforts should be made to prolong the gestational weeks as appropriate, but it is necessary to closely observe the fetal intrauterine conditions,evaluate the fetal conditions through ultrasound, and detect deficiency of amniotic fluid, fetal growth restriction, and fetal distress in a timely basis. lf necessary, the pregnancy should be terminated in time.
(3) For pregnant women after 32-34 weeks of pregnancy, if they have serious conditions of COVlD-19,delivery may be beneficial to the health of the mother; or if the conditions do not improve after treatment, the doctor then may consider terminating the pregnancy.
(4) lf the pregnant women have severe or critical conditions with COVlD-19, early termination of pregnancy must be considered, in order to protect the mother’s safety, regardless of the number of gestational weeks.