My First Trimester

Symptoms

According to infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security, all pregnant women should be aware of the symptoms of COVID-19. Symptoms may include:

• Fever
• Cough
• Shortness of breath
• Chills
• Repeated shaking
• Muscle pain
• Headache
• Sore throat
• New loss of taste or smell

This list is not all inclusive. The Centers for Disease Control and Prevention (CDC) believes at this time that symptoms of COVID-19 may appear in as few as 2 days or as long as 14 days after exposure.

Prevention/Precautions

The best way to prevent infection is to avoid being exposed to this virus. The CDC recommends:

• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
• If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Put distance between yourself and other people if COVID-19 is spreading your community. This is especially important for people who are at higher risk of getting very sick.
• Wear cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.
• If you are sick: You should wear a facemask, if available when you are around other people (including before you enter a healthcare provider’s office). 
• You should wear a facemask if you are caring for others.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

How Will This Impact My Pregnancy

Pregnant women must be proactive. They need to be aware of the symptoms of COVID-19 and take the necessary precautions to protect themselves and their babies. Expectant mothers should be extremely attentive to their health if they have a preexisting condition such as diabetes, hypertension or asthma to name a few.

Every pregnant mom must be informed of how COVID-19 is impacting her hospital and how these changes may impact her carefully thought out birth plan.

If you are planning on breastfeeding your baby, for information on how COVID-19 may impact breastfeeding, contact your local hospital, breastfeeding center or visit the Newborn Centers of Charleston  for the most current guidelines.

When to Seek Medical Attention

If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face

Call 911 if you have a medical emergency. Notify the operator that you have or think you might have COVID-19. If possible, put on a facemask before medical help arrives.

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

Treatment

If you think you may have been exposed to COVID-19, contact your healthcare provider immediately. Follow care instructions from your healthcare provider and local health department.

According to the Centers for Disease Control (CDC), the “risk to a developing fetus from vaccination of the mother during pregnancy is theoretical. No evidence exists of risk to the fetus from vaccinating pregnant women with inactivated virus or bacterial vaccines or toxoids. Live vaccines administered to a pregnant woman pose a theoretical risk to the fetus; therefore, live, attenuated virus and live bacterial vaccines generally are contraindicated during pregnancy.”

There are a few vaccines that are usually recommended before pregnancy. You may be familiar with three of the most common ones. The first is Influenza IIV (Inactivated). “Inactivated” means the vaccine does not contain a “live” virus. Vaccinations containing “live” viruses are contraindicated and not given to pregnant women per the CDC. The second recommended vaccine is Tdap (tetanus, diphtheria and pertussis). This vaccine is not only recommended for you, but also relatives, close friends and caregivers who will spend time with your baby. The third is MMR (measles, mumps and rubella). Measles contracted during pregnancy may be dangerous to pregnant women and result in miscarriage.

Several vaccinations are given “if indicated” before or after pregnancy. One reason a vaccine may be indicated is because you have the potential for exposure to an infection. For example, your health care team may suggest you be vaccinated for rabies if you are a technician working in a veterinarian’s office and may possibly come in contact with a rabid animal. Another reason a vaccine may be indicated is that you have a medical condition that increases your risk for contracting an infection. One example is that you may have had your spleen removed (splenectomy). Your spleen helps your body fight infections so your health care team may recommend that you receive the Pneumococcal vaccine to prevent pneumonia. Some other vaccinations which may be given “if indicated” before or after pregnancy are Hepatitis A, Hepatitis B, Meningococcal Polysaccharide/Conjugate, HPV (human papillomanvirus), Varicella (chicken pox) and Tetanus/Diphtheria (TD). Tdap is the preferred vaccination of choice over TD as it also contains pertussis (whooping cough).

The CDC states that if you are pregnant and not up to date on your flu vaccine, you may be at a higher risk for developing flu and flu-related complications. They recommend that all women who are or will be pregnant during the influenza season be vaccinated with the Influenza (Inactivated) vaccine.

The National Institute of Health (NIH) acknowledges the concern among pregnant women receiving Influenza (Inactivated) in a “multi-dose” form as it contains a small amount of mercury (thimerosal), a preservative. Although this vaccine has not been shown to cause attention deficit hyperactivity disorder or autism, the fear among expecting moms still exists. Routine vaccinations are available without the preservative thimerosal added. It is important that all pregnant women know that they may request their vaccination be free of this preservative if they so wish.

Every woman must thoroughly research any medication or vaccination recommended to her during pregnancy. Any concerns or the possible side effects of any medication or vaccination should be discussed with her health care team. Please refer to the March of Dimes and the CDC for more information on vaccinations before, during and after pregnancy, Guidelines for Vaccinating Pregnant Women, and breastfeeding and vaccinations.