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Practice Advisory: Novel Coronavirus 2019 (COVID-19)
The American College of Obstetricians and Gynecologists (ACOG) is closely monitoring the COVID-19 pandemic. Imported cases of COVID-19 infection in travelers have been detected in the United States, and person-to-person spread of COVID-19 also has been seen among close contacts of returned travelers from Wuhan. Community spread of COVID-19 has also been reported in several states.
Travel
Due to the current risk of COVID-19, CDC is continually updating travel recommendations. Please see CDC’s Coronavirus Disease 2019 Information for Travel page for the most up to date information
Additional travel advisories or restrictions may be implemented globally and locally within the United States depending on community spread.
Testing
Testing is currently occurring at state and local public health laboratories in 50 states and the District of Columbia.
Ob-gyns and other health care practitioners should contact their local and/or state health department for guidance on testing persons under investigation.
Pregnant Women
The American College of Obstetricians and Gynecologists & the Society for Maternal-Fetal Medicine have developed an algorithm to aid practitioners in assessing & managing pregnant women with suspect.
At this time, very little is known about COVID-19, particularly related to its effect on pregnant women and infants.
And there currently are no recommendations specific to pregnant women regarding the evaluation or management of COVID-19.
Community Mitigation Efforts
Community mitigation efforts to control the spread of COVID-19 are being implemented across the United States.
Infection Prevention and Control in Inpatient Obstetric Care Settings
The CDC has published Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings.
These considerations apply to health care facilities providing obstetric care for pregnant patients with confirmed COVID-19 or pregnant persons under investigation (PUI) in inpatient obstetric health
The American College of Obstetricians and Gynecologists encourages physicians and other obstetric care practitioners to read and familiarize themselves with the complete list of recommendations.
Key highlights from the recommendations include:
Health care practitioners should promptly notify infection control personnel at their facility of the anticipated arrival of a pregnant patient who has confirmed COVID-19 or is a PUI.
Patients with known or suspected COVID-19 should be cared for in a single-person room with the door closed. Airborne Infection Isolation Rooms should be reserved for patients undergoing aerosol-genera
Facemasks are an acceptable alternative when the supply chain of respirators cannot meet the demand. During this time, available respirators should be prioritized for procedures
Infants born to mothers with confirmed COVID-19 should be considered PUIs. As such, these infants should be isolated according to the Infection Prevention and Control Guidance for PUIs.
To reduce the risk of transmission of the virus that causes COVID-19 from the mother to the newborn, facilities should consider temporarily separating (eg, separate rooms) the mother who has confirmed
Discharge for postpartum women should follow recommendations described in the Interim Considerations for Disposition of Hospitalized Patients with COVID-19.
Due to the limited data on COVID-19, these recommendations are largely based on infection prevention and control considerations for other respiratory viruses such as influenza, SARS-CoV and MERS-CoV
Breastfeeding
The CDC has developed Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation for COVID-19.
There are rare exceptions when breastfeeding or feeding expressed breast milk is not recommended.
In limited case series reported to date, no evidence of virus has been found in the breast milk of women infected with COVID-19.
Additional Information
Currently, health officials are emphasizing that seasonal influenza remains a persistent concern for the U.S. population.
Influenza activity continues to be high across the US, and health care practitioners are encouraged to continue offering influenza vaccine to their unvaccinated patients, particularly pregnant women.
The American College of Obstetricians and Gynecologists will continue to closely monitor the evolution of the 2019 novel coronavirus (COVID-19) in collaboration with the CDC.
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