Vaginal delivery in women with COVID-19: report of two cases

BMC Pregnancy Childbirth. 2020 Oct 2;20(1):580. doi: 10.1186/s12884-020-03281-4.

Abstract

Background: During the ongoing global outbreak of COVID-19, pregnant women who are susceptible to COVID-19 should be highly concerned. The issue of vertical transmission and the possibility of neonatal infection is a major concern.

Case presentation: Case 1: A 35-year-old pregnant woman with a gestational age of 37 weeks and 6 days was admitted to our hospital at the point of giving birth. Except for the abnormalities in her chest CT image, she was asymptomatic. She had an uncomplicated spontaneous vaginal delivery, and her infant was discharged home for isolation. Because of the positive result of the maternal swabs for SARS-CoV-2 obtained on the 2nd day after sampling, we transferred the mother to the designated hospital and followed up with her by telephone interviews. Luckily, it was confirmed on February 23 that the newborn did not develop any COVID-19 symptoms after observation for 14 days after birth. Case 2: Another pregnant woman, with a gestational age of 38 weeks and 2 days, was also admitted to our hospital because of spontaneous labor with cervical dilation of 5 cm. Since she had the typical manifestations of COVID-19, including cough, lymphopenia, and abnormal chest CT images, she was highly suspected of having COVID-19. Based on the experience from case 1, we helped the mother deliver a healthy baby by vaginal delivery. On the 2nd day after delivery, the maternal nasopharyngeal swab result was positive, while the infant's result was negative.

Conclusion: There is still insufficient evidence supporting maternal-fetal vertical transmission for COVID-19-infected mothers in late pregnancy, and vaginal delivery may not increase the possibility of neonatal infection.

Keywords: COVID-19; Case report; Intrauterine vertical transmission; Vaginal delivery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Asymptomatic Infections*
  • Betacoronavirus
  • Breast Feeding
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / therapy
  • Cough
  • Delivery, Obstetric / methods*
  • Drugs, Chinese Herbal / therapeutic use
  • Female
  • Gestational Age
  • Humans
  • Lung / diagnostic imaging*
  • Lymphopenia
  • Masks
  • Oxygen Inhalation Therapy
  • Pandemics
  • Patient Isolation
  • Personal Protective Equipment
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / therapy
  • Polymerase Chain Reaction
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / therapy
  • SARS-CoV-2
  • Serologic Tests
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Antiviral Agents
  • Drugs, Chinese Herbal
  • lianhuaqingwen