Michigan Medicine Shares Plan to Limit Exposure of COVID-19 for Low Risk Pregnancies

Lisa Runnels

Are you pregnant and worried about the ongoing COVID-19 pandemic that has taken hold of the whole world? A multidisciplinary team at Michigan Medicine has come up with a plan to limit exposure of pregnant women seeking prenatal care to the coronavirus.

Michigan Medicine is a medical school at the University of Michigan. The health care complex has a long history of medical excellence in treatments, technological advancements, biomedical research and education.

The new plan has a three-pronged strategy: reduction of number of visits to the hospital to five, using as much telemedicine approach as possible, and using strict precautions when contact is vital. The health providers at Michigan Medicine think this plan will even work after the pandemic is over, for low risk pregnancies.

In-person visits for expectant mothers have been reduced to the initial prenatal visit, anatomy ultrasound and visits at 28, 36, and 39 weeks to monitor fetal development. All labs, exams, injections and imaging are to be conducted during these five times to limit exposure to the coronavirus.

The team has also advised that as much as possible any consultations that are not critical in nature should be limited to video calls and phone calls. They also proposed constant check on maternal care by remote monitoring of blood pressure, fetal heart tones and weight. This will be done by requesting parents to use measuring devices to record all these variables during video calls or e-visits.

However, women are encouraged to contact their health providers immediately if they feel anything is off or they need any advice.

The third initiative taken is to use strict precautions when dealing with expectant mothers like using cars as waiting areas, reducing their contacts with symptomatic patients and using CDC guidelines for any contact.

The team working at Michigan Medicine acknowledges that women are panicked everywhere about reduced in-person care, but they ensure that this model has been used in other care facilities before and has provided the levels of recommended care even when there are lesser in-person visits.

Source: Michigan Medicine

Dr Alex Peahl, M.D., is a Michigan Medicine obstetrician, gynecologist and researcher. She ensured that their team is doing everything to make sure that patients’ preferences and values during their birth experience do not suffer and the pandemic does not affect the approach to routine birth in anyway.

She adds:

COVID-19 has prompted us to get creative in how we support pregnant patients. We are setting up online groups where patients can be peer mentors and share their lived experience.

Current CDC Guidelines for Pregnancy and Breastfeeding

The Centers for Disease Control and Prevention (CDC) says that there are no known effects when it comes to pregnancy and coronavirus. The experts do not have enough information to suggest any detailed guidelines on the subject. However, preliminary guidelines suggest following recommendations should be adopted when handling pregnant women and new mothers:

  • Protection: Pregnant women are asked to follow same precautions as everyone else for the time being to avoid getting infected with coronavirus. These include keeping distance from other people (social distancing), avoiding physical contact when not needed, washing hands for 20 seconds, using alcohol-based hand sanitizer, avoiding people who are sick, using masks around sick people, coughing and sneezing into the elbow, among others.

  • Complications:No information is currently available on what complications can arise during childbirth, pregnancy or any adverse effects to the mother or the infant, due to coronavirus infection.

  • Transfer of Coronavirus to Infants: No details are available on if the coronavirus can transfer from mother to a child or not. Only one case of coronavirushas yet been seen in a newborn, but it was not clear whether the child got the infection from the mother or contracted it after birth. In small number of cases of pregnancy that were studied, no virus was found in amniotic fluid or in breast
  • Risks for Infants: This is another subject on which no information is yet available. In small number of cases where mother had coronavirus, problems with pregnancy like preterm birth were seen. However, it was not established if the infection was the cause of the problem or there were other factors involved.
  • Breastfeeding with Coronavirus Infection: The CDC does not have enough information to suggest what should be done in regard to breastfeeding in coronavirus infection. They suggest the decision should be taken by the mother in consultation with her healthcare provider on case to case basis. However, if she is feeding the child breast milk, precautions should be taken to limit the exposure of the child to the virus.
Source: World Health Organization

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