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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Care of the COVID-19 exposed complex newborn infant
Ganga Krishnamurthy1, Rakesh Sahni1, Tina Leone1
1Division of Neonatology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, NY.
Insights
This review discusses COVID-19 in pregnant women, noting mild courses for most but potential asymptomatic carriage. It highlights the need for understanding fetal impact and vertical transmission, emphasizing SARS-CoV-2
Area of Science:
- * Infectious Diseases
- * Maternal-Fetal Medicine
- * Neonatology
Background:
- * Coronaviruses, including SARS and MERS, have caused severe respiratory illness in pregnant women with adverse perinatal outcomes.
- * COVID-19 (Coronavirus Disease 2019) in pregnant women has generally presented as mild, with a significant proportion being asymptomatic carriers of SARS-CoV-2.
- * Limited data exists on the impact of COVID-19 on the fetus and the potential for vertical transmission.
Purpose of the Study:
- * To review current knowledge on COVID-19 in pregnancy, drawing from prior epidemic experiences.
- * To outline preparations and management strategies for deliveries involving mothers with COVID-19.
- * To emphasize the care of neonates, particularly those with complex health issues, born to mothers with COVID-19.
Main Methods:
- * Literature review synthesizing information from previous coronavirus epidemics (SARS, MERS) and emerging COVID-19 data.
- * Clinical perspectives from a single center in New York City, a pandemic epicenter.
- * Overview of established protocols for obstetric and neonatal care during the COVID-19 pandemic.
Main Results:
- * COVID-19 typically follows a mild clinical course in the majority of pregnant individuals.
- * Asymptomatic carriage of SARS-CoV-2 is common among pregnant women.
- * Significant knowledge gaps remain regarding fetal impact and vertical transmission of SARS-CoV-2.
Conclusions:
- * Recognize the high transmissibility of SARS-CoV-2 and its potential for severe disease in vulnerable populations, including healthcare workers.
- * Implement robust preparations for labor and delivery for mothers with COVID-19.
- * Prioritize specialized management for neonates born to mothers with COVID-19, especially those with pre-existing complex conditions.
Abstract:
As we confront COVID-19, the global public health emergency of our times, new knowledge is emerging that, combined with information from prior epidemics, can provide insights on how to manage this threat in specific patient populations. Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), both caused by coronaviruses, caused serious respiratory illness in pregnant women that resulted in adverse perinatal outcomes. Thus far, COVID-19 appears to follow a mild course in the vast majority of pregnant women. A significant proportion of pregnant women appear to be asymptomatic carriers of SARS-CoV-2. However, there is limited information on how COVID-19 impacts the fetus and whether vertical transmission occurs. While these knowledge gaps are addressed, it is important to recognize the highly efficient transmission characteristics of SARS-C0V-2 and its potential for causing serious disease in vulnerable individuals, including health care workers. This review provides perspectives from a single center in New York City, the epicenter of the pandemic within the United States. It offers an overview of the preparations required for deliveries of newborns of mothers with COVID-19 and the management of neonates with particular emphasis on those born with complex issues.
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