Latest Covid-19 Updates (June 2022)
June 2022
Corona updated guidelines (2022) from RCOG
· Pregnant women appear no more or less likely to contract SARS-CoV-2 than the general population, and more than two-thirds of identified pregnant women have no symptoms. The most common symptoms of COVID-19 in pregnant women are cough, fever, sore throat, dyspnoea, myalgia and loss of sense of taste.
· There is growing evidence that pregnant women may be at increased risk of severe illness from COVID-19 compared with non-pregnant women, particularly in the third trimester. The overall risk of death remains very low
· The Omicron variant may be associated with less severe disease than the Delta variant, but it is more infectious, and it is still likely to be associated with adverse maternal and neonatal outcomes, especially in pregnant women who are unvaccinated.
· Vertical transmission is uncommon.
· Maternal COVID-19 infection is associated with an approximately doubled risk of stillbirth and may be associated with an increased incidence of small-for-gestational age babies.
· Higher rates of perinatal mental health disorders have been reported during the pandemic, including anxiety and depression.
Vaccination
· Vaccination in pregnancy against COVID-19 is strongly recommended and pregnant women are a priority group for vaccination.
· There is no evidence to suggest that COVID-19 vaccines affect fertility. Women planning a pregnancy or fertility treatment can receive a COVID-19 vaccine and do not need to delay conception.
· There is excellent real-world evidence of vaccine efficacy with 98% of women admitted to hospital and getting severe infection having not had the vaccine.
· COVID-19 vaccines can be given at any time in pregnancy, including periconception, the first trimester, peri-birth and postpartum; this also includes after an uncomplicated assisted birth or caesarean birth. In pregnancy, the preference is to offer the Pfizer-BioNTech or Moderna vaccines.
· Pregnant women receiving a COVID-19 vaccine show similar patterns of reporting for common minor adverse effects to non-pregnant people. The rare syndrome of vaccine-induced thrombosis and thrombocytopenia (VITT) has been reported after the Oxford-AstraZeneca and the Janssen vaccines. It is an idiosyncratic reaction not associated with any of the usual venous thromboembolism risk factors. There is no evidence that pregnant or postpartum women are at higher risk of VITT than non-pregnant age-matched women.
· Breastfeeding women can receive a COVID-19 vaccine without having to stop breastfeeding.
Labour and birth
· In women with symptomatic COVID-19, there may be an increased risk of fetal compromise in active labour and of caesarean birth. Women with symptomatic suspected or confirmed COVID-19 should be advised to labour and give birth in an obstetric unit with continuous electronic fetal monitoring. This is not required for asymptomatic infection.
· Senior obstetric and medical input for a woman with severe or critical COVID-19 should be sought, particularly for decision making about birth.
· The level of personal protective equipment (PPE) required by healthcare professionals caring for a woman with COVID-19 who is undergoing a caesarean birth should be determined by the risk of her requiring intubation for a general anaesthetic. • Water birth is not contraindicated for women who are asymptomatic of COVID-19, providing adequate PPE can be worn by those providing care. Women with symptomatic COVID-19 should not labour or birth in water
· All pregnant women admitted with confirmed or suspected COVID-19 should be offered prophylactic low molecular weight heparin, unless birth is expected within 12 hours or there is significant risk of haemorrhage. The dose may need to be individualised for women with severe complications of COVID-19.
· All women who have been hospitalised and have had confirmed COVID-19 in pregnancy, or up to 6 weeks postpartum, should be offered thromboprophylaxis for at least 10 days following hospital discharge. A longer duration of thromboprophylaxis should be considered for women with persistent morbidity
· For unwell pregnant women in the third trimester, an individualised assessment should be undertaken by a multidisciplinary team to decide if maternal stabilisation is required before delivery can be undertaken safely. Following this, decisions concerning emergency caesarean birth or induction of labour should be prioritised, either to facilitate maternal resuscitation (including the need for prone positioning) or because of concerns regarding fetal health.
· Strongly consider treatment with monoclonal antibodies in pregnant and breastfeeding women who are unwell in hospital settings, particularly if they are unvaccinated and/or have additional risk factors for severe illness. Monoclonal antibodies are also recommended for those in the community who meet specific very high-risk criteria.
· Remdesivir should only be considered in pregnant women with COVID-19 who are not improving or who are deteriorating.
· Hydroxychloroquine, lopinavir/ritonavir and azithromycin should not be used as they are ineffective for treating COVID-19 infection. Molnupiravir is also not recommended in pregnancy until further studies have established its efficacy and safety
· Women should be informed that COVID-19 infection is not a contraindication to breastfeeding
30th Novemeber 2021:
JCVI: Reviewed Vaccine Response Measures to Omicron Variant
Yesterday, following the emergence of the Omicron variant, including confirmed cases in the UK, the Joint Committee on Vaccination and Immunisation (JCVI) has urgently reviewed vaccine response measures. The JCVI now advises:
All adults aged 18 to 39 years should be offered a booster dose, in order of descending age groups, to increase their levels of protection.
Booster doses should be given no sooner than three months after the primary course.
All severely immunosuppressed individuals should be offered their booster dose no sooner than three months after completing their primary course of 3 doses.
Young people aged 12 to 15 years should receive a second dose of the Pfizer-BioNTech COVID-19 vaccine, no sooner than 12 weeks after the first dose.
The booster will be offered in order of descending age groups, with priority given to the vaccination of older adults and those in a COVID-19 at-risk group. The overall intention of the measures advised above is to accelerate the deployment of COVID-19 vaccines and raise levels of protection across the population. We will share the link to further advice as it becomes available. You can also read the G7 joint statement on the Omicron variant.
15th April 2021: Update from NHS on Supporting pregnant women using maternity services during the coronavirus pandemic.
It covers three key actions which NHS trusts should take to enable women to receive support from a partner, relative, friend or other person when receiving maternity care during the COVID-19 pandemic.
Latest Human Fertilisation & Embryology Authority update: 8th April 2021
You can read the latest update from HFEA here https://www.hfea.gov.uk/treatments/covid-19-and-fertility-treatment/coronavirus-covid-19-guidance-for-patients/
Latest Royal College of Obstetricians & Gynaecologists update: 19th February 2021
You can read the latest update from Royal College of Obstetricians & Gynaecologists here https://www.rcog.org.uk/en/guidelines-research-services/coronavirus-covid-19-pregnancy-and-womens-health/
A message from Chana, November 2020
Dear friends and supporters,
As the UK enters a second lockdown we want to reassure both our clients and donors that we are here for couples, providing them with all the latest fertility information, advice and support.
Whilst fertility services are continuing, we understand this is a particularly anxious time for clients and are fortunate to have our in-house Scientific Advisor, Dr Veronique Berman, working alongside our Medical Advisory Panel of fertility specialists to access all the latest developments for patients.
Thanks to our strong links with the HFEA and professional relationships with clinics, we are able to pass this up-to-date information onto our clients, helping them to move forward at every stage of their journey. And this practical help goes hand-in-hand with our much-needed emotional support services, provided by our team of qualified fertility therapists for both couples and individuals.
The HFEA issued a statement this week to help ease patients’ anxiety, reassuring them that there are no plans to implement a national closure of fertility clinics. Increased guidelines and safety measures introduced in the spring for both patients and staff, means fertility services continue to be available. You can read the full statement from the HFEA here.
If this year has taught us anything, it is how to live with uncertainty in a continually changing world, something those struggling with infertility understand only too well, and so Chana’s message is one of hope - the hope for a brighter tomorrow.
During these strange times we are living in, instead of our usual much-loved Tea-cember campaign - we have an uplifting awareness campaign - which we would like you to share to coincide with Chanukah, during the first week of December.
We hope it will remind you that there will be better times ahead, that miracles are still happening and that Chana is doing everything we can to ‘keep hope alight.’
Keep safe and well,
The Team at Chana