Covid Hospital Protocols and the Pregnant Patient by Dianne Heidingsfelder, MS, RD, CDCES, LDN
As a RD and CDCES in the Maternal Fetal Medicine Department at Magee Womens Hospital of Pittsburgh, my patient population is all pregnant woman with diabetes. I wanted to take a closer look at our MFM department and our hospital’s COVID policies regarding our pregnant patients. I posed some questions that were answered by Christina Megli, MD, one of our physicians.
Current MFM protocol for Covid at Magee:
- Testing for Covid during pregnancy-regular testing or only when mother reports symptoms or has been exposed to the virus?
~We are only doing known exposure or symptoms. We do not have a protocol for regular testing. We are not doing universal testing on presentation to labor and delivery.
- Video visits vs in-person. What times in pregnancy are in-person exams required? ~We have a protocol for video visits, this was taken from protocols written pre-Covid era. In general, the late 3rd trimester visits are recommended in person.
- What are the effects of the mother contracting Covid on herself and fetus?
~We have no protocols regarding this. There was a meeting on NICHD (National Institute of Child Health and Human Development) recently regarding this. Symptomatic pregnant people with COVID-19 have increased risk of morbidity. The risk of fetal infection is very, very low (< 3%). There is controversy regarding risk of effects on the fetus regarding prematurity, fetal growth, etc.
- Are all patients recommended to get vaccinated? What are the side effects of the vaccine to mother and fetus?
~We are consistent with the WHO/CDC/SMFM and ACOG language and have several who are writing the guidelines. It is a risk benefit discussion to have with providers regarding vaccination.
- What are the delivery room protocol changes such as masks, testing for Covid, limit of number of family members, etc.?
~We continue to have limited visitors. We do not perform universal testing and have N95s available for all providers for delivery.
- What are the special concerns/precautions for pregnant women with a T1DM, T2DM or GDM diagnosis and the COVID pandemic?
~Although medical complications may increase complication rates in pregnancy, we do not have additional precautions in place. We recommend all patients mask, social distance and remain vigilant.
A special thanks to Dr. Megli for input!
To read more about COVID and pregnancy:
~ACOG (American College of Obstetricians and Gynecologists)
~NICHD (National Institute of Child Health and Human Development)
~SMFM (Society for Maternal Fetal Medicine)