Amid Covid surge, second wave nightmares still haunt pregnant women
As the Covid third wave is sweeping the country, the horrors of the first and second wave are still haunting the aged and people with comorbidities. So far this time though the severity of the disease is less, pregnant women, another most vulnerable section, are coping with the horrible memories of the second wave.
Anxious pregnant women are approaching doctors. Some of them inquire about abortions. They are not able to get their routine check-ups and most of them have opted for tele-counselling. However, foetus problems due to Covid during the first and second waves have not been proved so far. No case studies on malformations too have come to light. As many as 17 Covid positive women died post-delivery in Bengaluru alone during the second wave. The death of 28-year-old woman sub-inspector Shamili, serving in Dakshina Kannada district of Karnataka, who was in her seventh month of pregnancy has moved the state.
However, taking no chances, the Karnataka government has reserved two hospitals exclusively for the treatment of children and pregnant women due to the sudden surge in the number of cases amongst children and women in Bengaluru. The Commissionerate of Health and Family Welfare Services has declared that Indira Gandhi Institute of Child Health, located in Siddapura locality is reserved for the treatment of Pediatric Covid cases. Ghousia Maternity Hospital in Shivajinagar is reserved for pregnant women with Covid infection.
"With the onset of the Covid-19 third wave and the sudden surge in the number of Covid positive cases amongst children and women, it is necessary to have exclusive treatment facilities for them. Hence, these two hospitals are declared as Covid-19 hospitals, to treat children and pregnant women exclusively, with immediate effect," a circular said.
Pramila Naidu, president of the State Women's Commission who received appreciation from the National Commission for Women for her service to many expectant mothers and saving their lives during the Covid second wave, recounts how pregnant women who turned positive before three months of pregnancy were advised to terminate babies. "There were a lot of cases of premature deliveries. The requests poured in for rare blood groups for pregnant women. We attended and saved 22 cases all over the state. District Commissioners, Assistant Commissioners and nodal officers as well as hospital authorities responded and made arrangements for pregnant women. This time also the commission is ready to help. We have asked for a helpline from the government," she informed.
Dr Lakshmikanth, Associate Professor and Unit Chief, Cheluvamba Hospital in Mysuru, whose team monitored more than 250 deliveries of pregnant women who tested positive for Covid during the second wave, told IANS that this time the spread is more but the intensity of the first and second wave is not there. "We are suggesting 2 weeks prior admissions for pregnant women to monitor them effectively," he said.
"The pregnant women and their families are concerned that the child may be affected. They fear for their own lives and many sought abortions. But so far, there are no anomalies during births due to Covid. The Zika virus fear had created too much tension during the second wave," he stated.
Dr Gayathri Karthik Nagesh, HOD and Consultant - Obstetrics and Gynaecology, Manipal Hospital, stated that "it's a very varied response this time. A lot of people are in a state of panic because of what happened in the last wave. This wave seems to be spreading very fast, a lot of people are getting infected. But the cases that we have seen till now have not been severe."
"But, yes we are seeing an increase in milder infections. A lot of it is more like the common cold, we have a lot of patients with infections coming and a lot of them turning positive. But, the severity of the disease is not as much," she says. "Most of them are recovering well. We haven't had any need for admitting any pregnant woman to the ICU so far. The second wave was bad but this is not as bad as that," she adds.
"We have had many patients who have had premature deliveries. I can recall an instance where the mother had twins who came with severe disease and we had no choice but to deliver her in the ICU itself. We had to do a caesarean. The babies were fine and we shifted them out after a few days. The mother took a little longer time to recover, but she recovered. Fortunately, we had no maternal mortality at Manipal even in the Covid second wave, Even with the severe disease they were managed well," Nagesh says.
She advised the pregnant women to mask up, wash hands regularly and stay indoors. She asked them to hold tele-consultations and follow the doctor's instructions. Those pregnant women who have tested positive for Covid should consult an obstetrician or physician and get tested at regular intervals.
During the third wave of Covid, cough is more severe and also it is affecting the upper respiratory system rather than a lung infection. "We can't be placid about it and say it will not come and we have to keep a watch. Avoid going out, avoid interaction with people. Keep your distance from others even if they are family," she says.
Dr Devika Gunasheela, Managing Director of Gunasheela Surgical and Maternity hospitals, explained that this wave is not much of a problem as such. "Pregnant patients have tested positive for Covid. They usually have cough, cold, fever and bodyache. In about two or three days they are getting better. We have not seen anything during early pregnancy like abortions," she says.
"I have had a few patients who turned positive. One woman in her 37th week of pregnancy turned positive for Covid. She didn't even come to the hospital, the physician treated her over the phone. She had visited 10 days after having had the infection and she is now coming for caesarean section. I don't foresee any complications. There are no hospitalizations. They come fearfully to us complaining of fever, if tested they will turn Covid positive, after fever subsides they will go back home, our physicians also suggest best is home isolation. We separated them, one or two instances of newborn babies staying with mothers. But, no baby tested positive. The baby will have antibodies. This wave also means there will be no problems," she explained.
Dr Kiran Ashok, Gynaecology Specialist, ESI Hospital, Peenya Bengaluru, says the difference between normal patients and pregnant patients is that during pregnancy immunity will be less. As immunity will be less, the risk of getting Covid is more, people won't catch corona infection even if they are exposed due to good immunity. But, during pregnancy, once they get exposed they very easily catch the infection.
When there is a choice to be made between mother and child, the first priority is always given to the mother. We advise them to get vaccinated, earlier the guideline advised vaccinations after three months, now vaccination can be taken any time, he says.
"In the last one week, I have been seeing in the Out Patient Department (OPD), many pregnant women are coming with fever and cough and they test positive. We are following it up, so far symptoms are mild. No deterioration of health conditions or admissions to ICU," he said.
Vaccinated pregnant woman won't catch Covid. Secondly, the antibodies that get generated in the mother's body will secrete in mother's milk, the baby will get immunity. Babies get natural protection without any struggle against Covid. Covid positive mothers who have just delivered are advised to mask themselves before feeding the baby and avoid coughing on the baby. We advise them to continue breastfeeding, wash hands and feed the baby. During Covid the risk of bleeding is very high. We have to deliver in a well-equipped set up. Normal as well as caesarean, he said.
Dr K.V. Sreenivas, Consultant Physician and Associate Professor in Ambedkar Medical College, stated that not all medicines can be given during pregnancy. Any drug that affects the foetus can't be given.
Rohith Kumar, a software professional who became a father a week ago, stated that there is no need to panic. "We have taken precautions and kept in constant touch with the gynaecologist. It was a normal delivery without any complications. Mother and baby boy are doing just fine," he said.
Samskara, the mother, stated that the risk factor was always on her mind. However, consultations with her doctor and counselling helped her to get through negative thoughts. If guidelines are followed and standard operating protocols regarding Covid are followed by the pregnant women as well as their family members, there is no need to worry, she said. "I got vaccinated when I was in the sixth month of pregnancy. After vaccination, I could go for consultations and attend family functions without fear," she added.
Vedika, who works in a multinational company, stated that the lockdown period during the corona crisis helped them to go for a second kid. "The risks are always there. We settled for one kid. We never thought we would have another kid. However, the pandemic changed everything. Our companies supported us well. We are able to balance work as well as taking care of babies with the help of family members," she explained.