Home-care guidelines for patients with COVID-19

General advice for the care of pregnant or breastfeeding patients

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

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