The coronavirus epidemic has led to measures, such as the confinement of the population or the curfew in many countries, including France. How is this new measure and the climate of anxiety disrupting the monitoring of pregnancy for pregnant women?

Despite the measures and the current health situation, the obstetrician-gynecologists are doing everything they can to continue monitoring patients during pregnancy. In fact, only cases whose follow-up is specific, such as pregnancies, are maintained: more “simple” examinations and consultations are subject to teleconsultation or are quite simply postponed. Thus, the SYNGOF, National Union of Obstetrician Gynecologists of France, recommends teleconsultation when it is possible for all women, pregnant or not.

Pregnant women are at risk

According to the High Council of Public Health (HCSP), pregnancy, especially in the third trimester, can be a risk factor for a severe form of Covid-19. It is for this reason that he gives some advice to pregnant women during the Covid-19 crisis. Whatever the pregnancy period, the HCSP recommends raising awareness of barrier gestures and their application in the workplace, the promotion of influenza vaccination and the pursuit of professional activity, provided that working conditions and of transport allow the correct and strict application of the barrier measures. For pregnant women in the third trimester, teleworking should be preferred. They can make a request for partial activity or a work stoppage, prescribed by their doctor.

Pregnancy and vaccination against Covid-19

According to the Ministry of Health, pregnant women from the 2nd trimester of pregnancy can be vaccinated against Covid-19, in vaccination centers. Indeed, they are considered to present a risk of severe form of the disease. A study was conducted on 131 women including 84 pregnant women and 31 nursing mothers. They received one of two messenger RNA vaccines. The results are encouraging, as they have developed an effective immune response as well as antibodies transmitted to the baby. 

The Haute Autorité de Santé recommends that pregnant women take their 3 compulsory examinations, even during the health crisis. It is all the more important, to watch over the mother-to-be and the baby. In addition, she will be able to ask all these questions, whether or not relating to Covid-19. A pregnant woman can now be accompanied by a person, generally the future dad, on condition that they are both masked and that they strictly respect barrier gestures. Regarding follow-up appointments, tele-consultation should be favored. On the other hand, the birth preparation courses have resumed, in limited numbers. Health professionals are present for pregnant women: midwives, gynecologists, doctors. If they are anxious, do not hesitate to contact them.

Concerning the arrival at the maternity ward, questions are asked, in connection with the Covid-19. The goal is to find out if one or the other is showing symptoms. In the absence of clinical signs, the accompanying person can stay for the delivery and the stay that follows, under certain rather strict conditions. Visiting family and friends is not allowed. It is possible to organize for hospitalization and to anticipate by requesting this information in advance from the maternity ward. The stay in the birth department lasts 2 days for a vaginal delivery and 4 days for a cesarean delivery. A home visit with the midwife is expected for the baby between the 6th and 10th day.

During pregnancy three ultrasounds are mandatory and strongly recommended by SYNGOF. Each of these ultrasounds take place during a trimester:

• T1 ultrasound: which is carried out around the 12th week of amenorrhea;
• T2 ultrasound: which is carried out between the 22nd and the 25th week of amenorrhea;
• T3 ultrasound: which is carried out around the 32nd week of amenorrhea.

The National Union of Obstetrician Gynecologists of France nevertheless specifies that pregnant women must go alone to their follow-up appointment given the current situation and the high risk of transmission of the coronavirus.

In addition, in a press release dated March 17, 2020, the National Federation of Colleges of Medical Gynecology (FNCGM) invites women to postpone their non-urgent consultations to focus on monitoring pregnant women on the scheduled dates. Likewise, consultations regarding regular monitoring are maintained.

Finally, priority will also be put on the ground with the support of city gynecologists to relieve gynecological emergencies.

Pregnant women therefore keep the normal follow-up of their pregnancy, while respecting the prevention advice and taking care to apply the barrier measures communicated by the government. However, group childbirth preparation classes are canceled.

Indeed, the press release of the National Council of the Order of Midwives of March 15 urges liberal midwives to “Postpone activities that can be postponed, such as preparation for birth and parenthood”.

Update of November 24 – The competent health authorities and the Ministry of Solidarity and Health want to ensure good childbirth conditions during Covid-19 and the protection of caregivers. The good progress of childbirth is essential to promote the well-being of the mother and build a quality parent-child relationship. A protocol of care in maternity hospitals is applied. The High Council of Public Health indicates that everyone must be attentive to the health safety instructions during the stay in the maternity hospital. Concerning wearing a mask for a woman who gives birth, he is ” desirable in the presence of caregivers, but that it cannot in any case be made compulsory “. The presence of the father or a companion during childbirth is permitted and desirable. 

To best inform pregnant women, considered to be at risk of Covid-19, the High Public Health Committee has created a line for all pregnant women, without distinction.

Thus, each pregnant woman presenting symptoms of Covid-19, such as a cough and / or fever, must call 01 44 49 42 76 in order to obtain an appointment for an infection check-up. This number is open 24/24.