Home-care guidelines for patients with COVID-19

General advice for the care of pregnant or breastfeeding patients

Home-care guidelines for patients with COVID-19
  1. Additional resources
  2. Acknowledgements
  3. Disclaimer

The Royal Australasian and New Zealand College of Obstetricians and Gynaecologists notes:

  • pregnant patients with COVID-19 have a higher risk of morbidity and mortality compared with non-pregnant patients with COVID-19 of the same age, and are more likely to be hospitalised, be admitted to an intensive care unit (ICU) and to require invasive ventilation
  • pregnant patients who are overweight or obese (body mass index >30 kg/m2), have pre-existing hypertension or diabetes (type 1 or 2) are more likely to suffer severe COVID-19 than women without these conditions
  • an increased risk of miscarriage has not been identified for women trying to conceive or those in early pregnancy.19

The current recommendations for pregnancy and perinatal care from the National COVID-19 Clinical Evidence Taskforce (noting these would be considered in collaboration with obstetrics) include the following:

  • The use of antenatal corticosteroids for women at risk of preterm birth is supported as part of standard care, independent of the presence of COVID-19.
  • The use of magnesium sulfate in pregnancy for fetal neuroprotection for women at risk of preterm birth is supported as part of standard care, independent of the presence of COVID-19.
  • The use of magnesium sulfate in pregnancy for the management of severe pre-eclampsia or eclampsia is supported as part of standard care, independent of the presence of COVID-19.
  • The mode of birth should remain as per usual care, and currently no evidence supports that a caesarean section for women with COVID-19 reduces the risk of vertical transmission to the newborn. Respiratory deterioration due to COVID-19 might prompt urgent delivery on an individual basis.
  • Delayed umbilical cord clamping is supported as part of standard care, independent of the presence of COVID-19. 
  • Early skin-to-skin contact after birth and during the postnatal period is supported, independent of the presence of COVID-19. However, parents with COVID-19 should use infection prevention and control measures (mask and hand hygiene).
  • Breastfeeding is supported, irrespective of the presence of COVID-19. However, women with COVID-19 who are breastfeeding should use infection prevention and control measures (mask and hand hygiene) while infectious.
  • For women with COVID-19 who have given birth, support rooming-in of mother and newborn in the birth suite and on the postnatal ward when both mother and baby are well. However, women with COVID-19 should use infection prevention and control measures (mask and hand hygiene).20
  1. Communicable Diseases Network Australia. Coronavirus Disease 2019 (COVID-19): CDNA National guidelines for public health units. Version 6.7. Canberra: Department of Health, 2022 Content/cdna-song-novel-coronavirus.htm [Accessed 13 May 2022].
  2. Australian Technical Advisory Group on Immunisation. Clinical guidance for COVID-19 vaccine providers. Canberra; ATAGI, 2022 [Accessed 13 May 2022].
  3. Department of Health. How COVID-19 vaccines work. Canberra, 2022 vaccines/how-they-work [Accessed 19 may 2022].
  4. Rees S, Fisher J. COVID-19 and the mental health of people from refugee backgrounds. Int J Health Serv 2021;50(4):415–17. doi: 10.1177/0020731420942475.
  5. National COVID-19 Clinical Evidence Taskforce. Management of adults with mild COVID-19 (version 42.1). Melbourne, 2022 [Accessed 19May 2022].
  6. Community Health Pathways – NSW Collaboration. COVID-19 Active Case Management, 2022.
  7. National COVID-19 Clinical Evidence Taskforce. Pathways to care for adults with COVID-19 (version 4.2). Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  8. Agency for Clinical Innovation. Caring for adults and children in the community with COVID-19. Sydney: NSW Health, 2022 [Accessed 19 May 2022].
  9. National COVID-19 Clinical Evidence Taskforce. Pathways to care for children and adolescents with COVID-19 (version 2.1). Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  10. National COVID-19 Clinical Evidence Taskforce. Steroids for people with asthma or COPD and COVID-19. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  11. National COVID-19 Clinical Evidence Taskforce. ACEIs/ARBs in patients with COVID-19. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  12. National COVID-19 Clinical Evidence Taskforce. Oestrogen-containing therapies. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 10 June 2022].
  13. Cagnacci A, Bonaccorsi G, Gambacciani M, Board of the Italian Menopause Society Collaborators. Reflections and recommendations on the COVID-19 pandemic: Should hormone therapy be discontinued? Maturitas, 2020;138:76–77. doi: 10.1016/j.maturitas.2020.05.022.
  14. Australian Government Department of Health. Lagevrio (molnupiravir) PBS Factsheet. Canberra: DoH, 2022 [Accessed 11 July 2022]
  15. Australian Government Department of Health. Paxlovid® (nirmatrelvir and ritonavir) Pharmaceutical Benefits Scheme Factsheet. Canberra: DoH, 2022 [Accessed 11 July 2022]
  16. National COVID-19 Clinical Evidence Taskforce. Corticosteriods (systemic) for adults. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  17. Australian Government Department of Health. Guidance on the use of personal protective equipment (PPE) for health care workers in the context of COVID-19. Canberra: DoH, 2021 [Accessed 19 May 2022].
  18. Infection Control Expert Group. Information about cleaning and disinfection for health and residential care facilities. Canberra: Australian Government, 2020 coronavirus-covid-19-environmental-cleaning-and-disinfection-principles-for- health-and-residential-care-facilities-coronavirus-covid-19-environmental- cleaning-and-disinfection-principles-for-health-and-residential-care-fac.pdf [Accessed 19 May 2022].
  19. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Melbourne: RACGP, 2021. A message for pregnant women and their families information-for-pregnant-women [Accessed 19 May 2022]
  20. National COVID-19 Clinical Evidence Taskforce. Pregnancy and Perinatal care. Melbourne: National COVID-19 Clinical Evidence Taskforce, 2022 [Accessed 19 May 2022].
  21. The Royal Children’s Hospital Melbourne. Clinical Practice Guidelines – COVID-19. Melbourne: The Royal Children’s Hospital Melbourne, 2021 [Accessed 19 May 2022].
  22. National COVID-19 Clinical Evidence Taskforce. Management of people with COVD-19 who are older and living with frailty and/or cognitive impairment (version 5.0). Melbourne: National COVID-19 Clinical Evidence Taskforce, 2021 [Accessed 18 May 2022].

Advertising