Can a pregnant woman infection, can the fetus stay?"Following the New Crown Pneumonia Epidemic"

Author | Zhao Guangli

On February 5, Wuhan Children’s Hospital confirmed two cases of newborn new coronary virus pneumonia.Among them, the smallest baby was born for only 30 hours.

Will pregnant women infect the new coronal virus, will it be transmitted to children who have not yet been born?Do you want to terminate your pregnancy?

Previously, a well -known expert suggested that if the pregnant woman infected with new crown pneumonia, if the fetus was less than 3 months, she would "not advocate that she reserved (child)."

However, experts such as Huang Hefeng and other experts from the Academician of the Chinese Academy of Sciences and the Dean of the International Peace Maternal and Child Health Institute affiliated to the School of Medicine of Shanghai Jiaotong University said in an exclusive interview with the China Science News that "there is no clinical data confirmed that the infection of the new crown virus during pregnancy will cause fetal malformation and other risks."Therefore, for early pregnancy patients who are infected with new coronary viruses, they should not blindly adopt a scheme of" termination of pregnancy ". It is recommended to perform individualized treatment according to explicit causes.

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New crown virus lacks evidence through vertical transmission of mother fetus

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"China Science News": What do you think of Wuhan Children’s Hospital, there is a situation of "newborn was born in only 30 hours infection with new crown pneumonia"?

▲ Huang Hefeng:

The newborn infected with the new coronary virus discovered by Wuhan Children’s Hospital not only allows the pregnant women who are originally anxious to start to doubt whether they can keep the first level of life for the baby to keep their lives in a very time. The period of obstetrics in the period was placed in front of my country’s obstetrics and gynecology experts -a new coronary virus can spread vertically by maternal and infants?

"Journal of Science": There are indeed experts that there may be a way to spread vertical infection of mothers and infants. How do you look at this problem?

▲ Jin Li (Director of Assistant Reproductive Department of International Peace and Child Health Hospital affiliated to Shanghai Jiaotong University School of Medicine):

Vertical transmission is also called maternal and infant transmission. It refers to the pathogens of maternal mothers to future generations through placenta, birth canal or breastfeeding. Among them, virus is more common, such as rubella virus, hepatitis B virus, and HIV.

For any virus infection, early pregnancy (before 13 weeks of pregnancy) is a special period, because this stage is in an important period of fetal organs (also known as teratogenic sensitive period).

Infection at this stage often affects the normal development of organs.During this period, it should be more concerned about whether the virus will occur through the placenta.

▲ Huang Hefeng:

However, as far as the new coronary virus is concerned, there is no clinical data confirmed that infection during pregnancy can lead to fetal malformations and other risks.

As far as the analysis of several existing cases of pregnancy and late pregnancy, we have not detected new coronary viruses in their placenta, amniotic fluid, and umbilical blood.This is evidence that the new coronary virus can spread through the placenta.

The results of the infected newborns mentioned earlier, his placenta and umbilical blood virus tests are also negative, so there is no sufficient evidence that it proves that it is infected by the mother’s birth.

The "China Science News" also learned that in this regard, Qiao Jie, a member of the National Medical Team of Hubei, an academician of the Chinese Academy of Engineering, and the dean of the Third Hospital of Peking University, also proposed that the current data is very limited. At presentVertical transmission; and among the 10 maternal women who have observed patients with new crown pneumonia, their nucleic acid detection of birth baby birth babies is negative.

As for the nucleic acid test in media reports as a positive newborn, she believes that there are different contacts with delivery during testing, "it is not ruled out that it is infected by other means."

It is recommended not to blindly "one -size -fits -all" to terminate pregnancy

"China Science News": Is there any place to learn from the experience and lessons of the atypical pneumonia (SARS) epidemic?

▲ Huang Hefeng:

Looking at the results of vertical communication research in the middle and late pregnancy of coronary viruses, most studies do not support the presence of maternal fetal dissemination.

Although a small number of documents mentioned 4 of the 7 patients with early pregnancy, 4 natural abortion occurred, suggesting that the disease itself had a death effect on the development of early embryo development.

However, considering the high proportion of SARS severe illnesses, there are many patients with minor illnesses in the new coronary virus infection. Therefore, we recommend that early pregnancy patients with new coronary virus infection can be performed individually according to their own.One knife cuts the "termination of pregnancy" scheme.

"China Science News": What suggestions do you have for patients with different severe infections?

▲ Ding Guolian (Deputy Researcher of the China Welfare Association International Peace and Child Health Hospital, deputy chief physician of reproductive medical):

First of all, if you are a mild patient, you should try to take a relatively mild treatment plan to avoid using drugs that are damaged to the fetus.

Secondly, pregnant women often need higher oxygen. Therefore, it is necessary to pay more attention to the monitoring of hypoxemia in pregnant women. Once the hypoxia is found, it should be intervened as soon as possible to correct it in time.

At the same time, pregnant women are in a period of special needs for nutrition and psychology, so they should pay more attention to providing sufficient nutrition and good environment and psychological support.

▲ Huang Hefeng:

When you need to use special drugs, you should fully notify the safety of related drugs.

For example, Redsovir, which is currently hotly debated, has confirmed that the pathogens of SARS and Middle East Breathing Syndrome (MERS) have good therapeutic effects.

These viruses are coronary viruses and the new coronary virus in 2019-NCOV, and they have similarity in structure.Therefore, the medicine can skip the clinical trials of Phase I and II in China, and directly enter the phase III clinical experiments, with a view to the as soon as possible to invest in my country’s epidemic prevention and control.

However, "no one is perfect, and the gold has no barefoot." At present, some studies have shown that the drug has a certain toxicity in the liver and mitochondria, and the safety of its pregnancy is to be further confirmed.

In addition, during the pregnancy of pregnant women, the intra -fetal intrauterine monitoring should be strengthened, such as continuous ultrasound examination and assessment of the fetal structure and growth and development. If necessary, the magnetic resonance examination and prenatal diagnosis screening can be used.

"China Science News": What about patients with severe infection?

▲ Jin Li:

For patients with severe early pregnancy, the safety of maternal physical safety is the first priority.

Infected with the following severe symptoms: respiratory distress (RR ≥ 30 times/minute); in a static state, finger oxygen saturation ≤ 93%or arterial blood oxygen pressure (PAO2)/oxygen concentration (FIO2) ≤300mmHg;When respiratory failure and mechanical ventilation; shock or other organ failure requires ICU monitoring treatment, in order to save pregnant women’s lives, it should be recommended to terminate pregnancy.

▲ Huang Hefeng:

In addition, in order to better evaluate the risk of continued pregnancy infected with early pregnancy infected with new coronary viruses, we also need to pay attention to: the load (nucleic acid testing of nucleic acid testing) of pregnant women’s virus is the first generation of infected people.More than two lung leaves, as well as whether the pregnant woman is old or merged with basic diseases (diabetes, hypertension, etc.).

(Reporter Zhang Siwei, trainee reporter Gao Yali also contributed to this article)

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