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 .