COVID-19: Effects in Comorbidities and Special Populations

COVID-19 and Pregnancy

Author(s): Alka Sehgal and Neelam Aggarwal * .

Pp: 263-290 (28)

DOI: 10.2174/9789815036367122010011

* (Excluding Mailing and Handling)

Abstract

The SARS-CoV-2 pandemic has emerged as an unprecedented challenge to the current medical practice, including obstetrics. Being an acute situation, there is limited experience of the impact of COVID-19 in pregnancy. Various management protocols are being evaluated and modified frequently to address key concerns of maternal and neonatal health. Pregnancy is a unique bundle of two lives, and the physiological adaptation to the dual life adds to the uniqueness. The effect of COVID- 19 and its treatment on pregnancy (mother and fetus) and vice-versa, is a common quest for all pathologies. The other concerns are vertical and horizontal transmission in antepartum, intrapartum, and postpartum periods, respectively. The immunosuppression as a part of physiological changes during pregnancy apparently raises apprehension of higher risk of viral infection or probability of severity of infection during pregnancy. The same has also been observed with previous virus infections in history like severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), etc., although available literature suggests that the risk of developing COVID-19 for pregnant women is not similar to the non-pregnant adult population. The small risk of developing a serious condition during pregnancy is inevitable, and the contagiousness of the virus is a major concern for the neonate and attending family. Some overlapping features of complicated pregnancy with severe COVID-19 require attention. Social distancing, anxiety, and psychological stress need to be kept in mind. There is an impact of financial stress on family; domestic violence can also not be undermined during this crisis period. Access to health facilities may also be affected in developing countries due to the lockdowns, quarantine of pregnant women, caretakers, or health care workers (HCW), etc. The aerosol production during the intrapartum phase is challenging for both vaginal and abdominal routes of delivery, but the management of sudden catastrophic, life-threatening conditions associated with pregnancy can be a real threat for the team of health care workers. It is still early to comment on the long-term effects of the viral infection on the foetus, especially the exposure during the rapid embryogenesis period.


Keywords: ACOG advisory, Aerosols, Aerosol Generating Procedure (AGP), Corona Virus Disease, COVID-19, COVID and Preeclampsia, COVID Pneumonia, COVID-19 Transmission, Droplet Infection, Infant Mother Dyad MERS, Pandemic, PPE, N95, Nasopharyngeal Swab, Respirator, RT-PCR, SARS-CoV-1, SARS-CoV-2, Surface Fomites, Surgical Mask, Temporary Separation, Vertical transmission in COVID-19.

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      • 12. app/Http/Controllers/ChapterController.php:1465
      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
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      • 11. app/Models/ContentAccess.php:647
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      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51408323 and j.to_ip >=51408323 )) and ((j.from_date <= 1739847275 and j.to_date >= 1739847275 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 17612) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51408323 and j.to_ip >=51408323 )) and ((j.from_date <= 1739847275 and j.to_date >= 1739847275 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 17612) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51408323 and j.to_ip >=51408323 )) and ((j.from_date <= 1739847275 and j.to_date >= 1739847275 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 17612)
      590μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 3392 and `b`.`banner_from_date` <= 1739847275 and `b`.`banner_to_date` >= 1739847275 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.1msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 3392
      • 3: 1739847275
      • 4: 1739847275
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='e3a67a46326d53e83af0ad77ba4013d5'
      240μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    22Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        rByaGwo8TNUXdHpzbd8zBPdeLKClKyGW9sFc4Gyd
        uc_cart_id
        e3a67a46326d53e83af0ad77ba4013d5
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/17612" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/17612
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:16 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        []
        
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Tue, 18 Feb 2025 02:54:35 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlBqeWg3TG4xbW5RNjdOVVV2cW1xb2c9PSIsInZhbHVlIjoiTzhJVmFXY0U1cDhaRWF4WmRmcVRIR2NFYk5leU5LV0ZaUHBpbGtwK1A4MlRlR0llK3VhWlNGQitMamVkZ3NSWnJVbU55RVpNcm43Q1cwUWVPOFlQMTF5dENhSnFRVW1DLzdsV0hUdEI3bURJL1FnQjF4K2ZxQVJXRU5BTGFYK3AiLCJtYWMiOiI1NGY2ZjU1MTNlNDc4MjkwMjM0OTI3Nzc2MGI2ZmFhYzJiMmI4ZmM4MzBjYmJlMGNiNjUxYTgwYWE3ODU4MjY0IiwidGFnIjoiIn0%3D; expires=Thu, 20 Feb 2025 14:54:35 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IlBqeWg3TG4xbW5RNjdOVVV2cW1xb2c9PSIsInZhbHVlIjoiTzhJVmFXY0U1cDhaRWF4WmRmcVRIR2NFYk5leU5LV0ZaUHBpbGtwK1A4MlRlR0llK3VhWlNGQitMamVkZ3NSWnJVbU55R" 1 => "alphaeurekaselectnet_session=eyJpdiI6InR0bEt4WHIzZUxWN096Z1kvOElRb3c9PSIsInZhbHVlIjoiODZOK3RRaWdpKzArNkZkTkZBYVE5WlFlWXorZ1Q3L3F1SVBtSi9mZ2RCdlNWS1huWnQ5SktGK1Y3NDdVZXlpMmltaEhvV2JnSVB4bUc2TUxuN05pY20zbkFTRFd5bm5pQlZDQmRXL2FSb3I3VXFsVnBHa0M0VVJlU0FsQXdZNEkiLCJtYWMiOiIzYTIxODA2Nzc2ZThmYjA5N2QyNWNlYzgzYWJlOWZkMjllMzIwZWYyZGIwNTZlYzliMjBlYzIxOTc1ZDZkZGFlIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6InR0bEt4WHIzZUxWN096Z1kvOElRb3c9PSIsInZhbHVlIjoiODZOK3RRaWdpKzArNkZkTkZBYVE5WlFlWXorZ1Q3L3F1SVBtSi9mZ2RCdlNWS1huWnQ5SktGK1Y" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlBqeWg3TG4xbW5RNjdOVVV2cW1xb2c9PSIsInZhbHVlIjoiTzhJVmFXY0U1cDhaRWF4WmRmcVRIR2NFYk5leU5LV0ZaUHBpbGtwK1A4MlRlR0llK3VhWlNGQitMamVkZ3NSWnJVbU55RVpNcm43Q1cwUWVPOFlQMTF5dENhSnFRVW1DLzdsV0hUdEI3bURJL1FnQjF4K2ZxQVJXRU5BTGFYK3AiLCJtYWMiOiI1NGY2ZjU1MTNlNDc4MjkwMjM0OTI3Nzc2MGI2ZmFhYzJiMmI4ZmM4MzBjYmJlMGNiNjUxYTgwYWE3ODU4MjY0IiwidGFnIjoiIn0%3D; expires=Thu, 20-Feb-2025 14:54:35 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IlBqeWg3TG4xbW5RNjdOVVV2cW1xb2c9PSIsInZhbHVlIjoiTzhJVmFXY0U1cDhaRWF4WmRmcVRIR2NFYk5leU5LV0ZaUHBpbGtwK1A4MlRlR0llK3VhWlNGQitMamVkZ3NSWnJVbU55R" 1 => "alphaeurekaselectnet_session=eyJpdiI6InR0bEt4WHIzZUxWN096Z1kvOElRb3c9PSIsInZhbHVlIjoiODZOK3RRaWdpKzArNkZkTkZBYVE5WlFlWXorZ1Q3L3F1SVBtSi9mZ2RCdlNWS1huWnQ5SktGK1Y3NDdVZXlpMmltaEhvV2JnSVB4bUc2TUxuN05pY20zbkFTRFd5bm5pQlZDQmRXL2FSb3I3VXFsVnBHa0M0VVJlU0FsQXdZNEkiLCJtYWMiOiIzYTIxODA2Nzc2ZThmYjA5N2QyNWNlYzgzYWJlOWZkMjllMzIwZWYyZGIwNTZlYzliMjBlYzIxOTc1ZDZkZGFlIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6InR0bEt4WHIzZUxWN096Z1kvOElRb3c9PSIsInZhbHVlIjoiODZOK3RRaWdpKzArNkZkTkZBYVE5WlFlWXorZ1Q3L3F1SVBtSi9mZ2RCdlNWS1huWnQ5SktGK1Y" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "rByaGwo8TNUXdHpzbd8zBPdeLKClKyGW9sFc4Gyd" "uc_cart_id" => "e3a67a46326d53e83af0ad77ba4013d5" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/17612" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-18 02:54:35GET/chapter/176121121924