Interpretation
1. Delivery Methods for pregnant womenwith confirmed or suspected COVID-19
As we all known, the COVID-19 is highly infectious, and due to the pathophysiological changes during pregnancy, the SARS-CoV-2 infection in pregnancy women is easy to progress to severe disease, and the risk of adverse pregnancy outcomes is high9 . In principle, caesarean section is recommended to terminate pregnancy during the epidemic period6 . In the following cases, caesarean section should be the main choice: With pregnancy-related complications and has indications for emergency cesarean section; Already in labor, but the conditions for vaginal delivery are not good enough to make a short-term vaginal delivery; Pregnant women with severe or critical COVID-195 cannot tolerate vaginal delivery.
In our research, the 10 cases of pregnant women with clinical diagnosis COVID-19 in isolation ward terminated pregnancy by vaginal delivery were classified as mild patients in combination with the results of laboratory and imaging examination. After admission, they already had regular uterine contraction, the fetal head was well connected, the fetal presentation was low, and all of them have officially entered the labor process. Therefore, we believe that there is no indication for cesarean section. The primipara is in the late stage of the active period or enters the second stage of labor, the relationship of fetal head and pelvic is good, it is estimated that the vaginal delivery can be performed in a short time. The multipara has already entered the labor process, the relationship of fetal head and pelvic relationship is good, it is estimated that the vaginal delivery can be performed within a short time. Vaginal delivery can also be selected in the above cases. Before deciding on the delivery method, in addition to the rapid improvement of routine laboratory tests, SARS-CoV-2 nucleic acid throat swab test, serum SARS-CoV-2 antibody test, and other respiratory pathogen detection which is helpful for differential diagnosis should be also finished. If necessary, perform bedside ultrasound to assess the situation of the fetus and appendages. Pregnant women are the same as non-pregnant patients. X-rays and CT are important methods for diagnosing COVID-19 and evaluating the condition. When necessary, check the lung CT (radiation low-dose screening for lung CT with conditions available) under the radiation protection of the pregnant woman with abdominal lead covering, which can be used to evaluate the lung lesions10 .