Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection

Dunjin Chen; Huixia Yang; Yun Cao; Weiwei Cheng; Tao Duan; Cuifang Fan; Shangrong Fan; Ling Feng; Yuanmei Gao; Fang He; Jing He; Yali Hu; Yi Jiang; Yimin Li; Jiafu Li; Xiaotian Li; Xuelan Li; Kangguang Lin; Caixia Liu; Juntao Liu; Xinghui Liu; Xingfei Pan; Qiumei Pang; Meihua Pu; Hongbo Qi; Chunyan Shi; Yu Sun; Jingxia Sun; Xietong Wang; Yichun Wang; Zilian Wang; Zhijian Wang; Chen Wang; Suqiu Wu; Hong Xin; Jianying Yan; Yangyu Zhao; Jun Zheng; Yihua Zhou; Li Zou; Yingchun Zeng; Yuanzhen Zhang; Xiaoming Guan

doi:10.1002/ijgo.13146

Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection

Int J Gynaecol Obstet. 2020 May;149(2):130-136. doi: 10.1002/ijgo.13146. Epub 2020 Apr 1.

Authors

Dunjin Chen^#¹, Huixia Yang^#², Yun Cao³, Weiwei Cheng⁴, Tao Duan⁵, Cuifang Fan⁶, Shangrong Fan⁷, Ling Feng⁸, Yuanmei Gao⁹, Fang He¹, Jing He¹⁰, Yali Hu¹¹, Yi Jiang¹², Yimin Li¹³, Jiafu Li¹⁴, Xiaotian Li¹⁵, Xuelan Li¹⁶, Kangguang Lin¹⁷, Caixia Liu¹⁸, Juntao Liu¹⁹, Xinghui Liu²⁰, Xingfei Pan²¹, Qiumei Pang²², Meihua Pu²³, Hongbo Qi²⁴, Chunyan Shi², Yu Sun², Jingxia Sun²⁵, Xietong Wang²⁶, Yichun Wang⁹, Zilian Wang²⁷, Zhijian Wang²⁸, Chen Wang², Suqiu Wu²⁹, Hong Xin³⁰, Jianying Yan³¹, Yangyu Zhao³², Jun Zheng³³, Yihua Zhou³⁴, Li Zou³⁵, Yingchun Zeng¹, Yuanzhen Zhang¹⁴, Xiaoming Guan³⁶

Affiliations

¹ Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou City, Guangdong Province, China.
² Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
³ Department of Neonatology, Children's Hospital Affiliated of Fudan University, Shanghai, China.
⁴ Department of Obstetrics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Shanghai, China.
⁶ Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China.
⁷ Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China.
⁸ Department of Perinatal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
⁹ Department of Critical Care Unit, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China.
¹⁰ Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine Hangzhou, Hangzhou, Zhejiang Province, China.
¹¹ Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, JiangSu Province, China.
¹² Department of Pediatrics, Peking University First Hospital, Beijing, China.
¹³ Department of Critical Care Unit, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China.
¹⁴ Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China.
¹⁵ Department of Obstetrics, Obstetrics and Gynecology, Hospital of Fudan University, Shanghai, China.
¹⁶ Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi Province, China.
¹⁷ Department of Affective Disorder, Brain Hospital Affiliated of Guangzhou Medical University, Guangzhou, Guangdong Province, China.
¹⁸ Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, , Liaoning Province, China.
¹⁹ Department of Obstetrics and Gynecology, Chinese Academy of Medical Sciences & Peking Union Medical college Hospital, Beijing, China.
²⁰ Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, China.
²¹ Department of Infectious Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China.
²² Department of Obstetrics and Gynecology, You'an Hospital, Capital Medical University, Beijing, China.
²³ Department of Pediatrics, Peking University Third Hospital, Beijing, China.
²⁴ Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
²⁵ Department of Obstetrics and Gynecology, The First Affiliated Hospital of Harbin Medical University, Harbin, Helongjiang Province, China.
²⁶ Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University, Shandong Province, China.
²⁷ Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
²⁸ Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
²⁹ School of Health Education of Wuhan University, Wuhan, Hubei Province, China.
³⁰ Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Hebei Medical University, Hebei Province, China.
³¹ Department of Obstetrics, Fujian Provincial Maternity and Children Hospital, Fuzhou, Fujian Province, China.
³² Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
³³ Department of Neonatology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China.
³⁴ Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China.
³⁵ Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
³⁶ Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.

^# Contributed equally.

Abstract

Objective: To provide clinical management guidelines for novel coronavirus (COVID-19) in pregnancy.

Methods: On February 5, 2020, a multidisciplinary teleconference comprising Chinese physicians and researchers was held and medical management strategies of COVID-19 infection in pregnancy were discussed.

Results: Ten key recommendations were provided for the management of COVID-19 infections in pregnancy.

Conclusion: Currently, there is no clear evidence regarding optimal delivery timing, the safety of vaginal delivery, or whether cesarean delivery prevents vertical transmission at the time of delivery; therefore, route of delivery and delivery timing should be individualized based on obstetrical indications and maternal-fetal status.

Keywords: COVID-19; Expert consensus; Management guidelines; Neonates; Pregnant women.

MeSH terms

Betacoronavirus
COVID-19
China
Consensus
Coronavirus Infections / therapy*
Coronavirus Infections / virology
Delivery, Obstetric / methods
Female
Humans
Infant, Newborn
Infection Control / methods
Infectious Disease Transmission, Vertical / prevention & control*
Pandemics
Pneumonia, Viral / therapy*
Pneumonia, Viral / virology
Pregnancy
Pregnancy Complications, Infectious / therapy*
Pregnancy Complications, Infectious / virology
Risk Factors
SARS-CoV-2