Insights

 

INSIGHTS & FAQ FEEDBACK

Overview

“Pregnant women do not appear more likely to contract the infection than the general population. Pregnancy itself alters the body’s immune system and response to viral infections in general, which can occasionally cause more severe symptoms, and this will be the same for COVID-19.”

COVID-19 AND PREGNANCY Q&A

Can a newborn catch Covid-19 at birth?

  • Yes, they can be infected either by contact with their covid_19 positive mother at birth or they may get infected in the nursery if they are placed close to another infected newborn baby.
  • However, a mother who had the disease and recovered or in the process of recovery is likely to have transmitted viral particles to the fetus who would be born with immunity to the virus and thus may not be infected even if in the close vicinity of infected people.
  • Infants born to mothers with known COVID-19 at the time of delivery should be considered infants with suspected COVID-19. As such, infants with suspected COVID-19 should be isolated from other healthy infants and cared for as persons under investigation.
  • Physical contact between a mother and a newborn is critical and separating them at birth may have long-term consequences, both the CDC and RCOG advise that this be done on a case by case basis. The general rule is that the baby should be protected from infection from the mother and thus if physical contact is to happen, the baby needs to be shielded.

Can a pregnant mother be flu vaccinated?

    • Yes, they can, and they should so that they avoid getting the ordinary flu during this time of the pandemic.

What if you are a frontline worker and you are pregnant?

    • Practice the universal rules of basic hygiene, make sure you have PPE at all times, wash hands or sanitize in between each client; if you are wearing surgical gloves, either you use a new pair for each client or sanitize the gloves in-between your client.
    • Do not be complacent, keep your mask on and do not touch the front of the mask at any time.

What evidence so far to date on the risks to pregnancy?

    • So far, the virus does have not been found in breast milk, cord blood or amniotic fluid, BUT there has IGM antibodies against COvid_19 have been found in the babies born from Covid_19 positive mothers, this means that there is vertical transmission from mother to baby.
    • At present there is one published case of a woman with severe COVID-19 who was admitted to hospital at 34 weeks’ gestation and gave birth to a stillborn baby by c/section and was admitted to the intensive care unit with multiple organ dysfunction and acute respiratory distress syndrome, requiring ICU ventilation.
    • There is also an increased risk of preterm birth (deliveries) being indicated for maternal medical reasons after 28 weeks’ gestation to allow for optimum treatment of the mother.

How does pregnancy affect disease progression?

  • It has long been known that, whilst pregnant women are not necessarily more susceptible to viral illness, changes to their immune system in pregnancy can be associated with more severe symptoms and this will be the same for COVID-19.
  • Most women will experience only mild or moderate cold/flu like symptoms. Cough, fever and shortness of breath are other relevant symptoms.
  • More severe symptoms such as pneumonia and marked hypoxia could occur in pregnant women so should be identified and treated promptly.
  • There are significant increases in critical illness in later pregnancy, compared with early pregnancy


Advice for all pregnant women

  • Antenatal and postnatal care are essential care and we encourage women to attend while observing all basic rules of hygiene and social distancing measures.
  • Smoking is associated with worse outcomes for COVID-19, we advise women to quit smoking cigarette.
  • Practice strict social distancing and when needed self-isolation especially those who are 28 weeks and above
  • This pandemic will inevitably result in an increased amount of anxiety in the general population, and this is likely to be even more so for pregnant women as it represents an additional period of uncertainty. Specifically, these anxieties are likely to revolve around:
    • COVID-19 itself.
    • The impact of social isolation resulting in reduced support from wider family and friends.
    • The potential of reduced household finances.


Is there a special diet the pregnant women can follow?

  • The diet that is advised to all pregnant women regardless of Covi_19 status is that of:
    • A balanced diet
    • Avoid uncooked food like sushi, medium rare steaks raw eggs etc
    • Prepare you own green salad making sure you wash all the ingredients with iced water.
    • Take supplements as prescribed by your health care provider (midwife, GP, specialist).


How do they protect themselves?

  • Universal precautions and general hygiene principles:
    • Social distancing
    • Wash or sanitize hands regularly
    • Avoid touching you face with unwashed hands
    • Self-isolation.

 

INSIGHTS & FAQ FEEDBACK

Overview

“The treatment methods that rejuvenate vaginal skin and make it functional again are not only cosmetic but critical in preventing and treating conditions like BV and pruritis vulvae.”

BACTRIAL VAGINOSIS AND VAGINAL REJUVINATION

A healthy vagina is defended by ‘healthy’ microbes or bacteria including lactobacillus the most important one. The symbiotic relationship between these bacteria and their human host (the women) is modulated by hormones that are circulating in the woman’s body and stimulate vaginal epithelia to produce glycogen, the lactobacillus need the glycogen to produce lactic acid which keeps the vaginal PH below 4,5. It is the acidic environment of the vagina that defends it from invasion by foreign bacteria. Lactobacillus also fend off foreign bacteria by competitive exclusion where they just occupy space in the vagina and production of hydrogen peroxide which is antibacterial to foreign bacteria.

Bacterial Vaginosis (BV) occurs when lactobacillus is replaced in the vagina by anaerobes like Gardnerella; once Gardnerella invades, the other anaerobes follow, and this includes viruses like HIV.
Epidemiological studies have over the years shown that the risk of BV is high among those of African ethnicity, those who use douches, uncontrolled use of antibiotics, etc.

Therefore, the basic premise treating any condition is to deal with the cause, and in preventing BV we need a healthy vaginal skin that can continually produce the glycogen, which lactobacillus needs to fend off the anaerobes. The treatment methods that rejuvenate vaginal skin and make it functional again are not only cosmetic but critical in preventing and treating conditions like BV and pruritis vulvae.

Medical Laser stimulates rejuvenation through regrowth of tissue including vaginal skin, the use of Vaginal laser like FEMILIFT® for rejuvenating the skins starts the process where the defenses of the vagina are built up again, estrogen and other hormones bring enough glycogen to the vaginal skin and that allows the population of lactobacillus to grow and rebuild the defenses of the vagina against the anaerobes.

The ‘O’ Shot® using PRP (Platelet Rich Plasma) is full of growth factors and stem cells that also are critical in rejuvenating vaginal skin to achieve the same ideal of a healthy, tighter and rugae filled vagina that has regained its lubrication and elasticity and hence great for all its functions including intercourse and the resultant orgasms.

Once lactobacillus is restored, the PH is dropped to the acceptable number below 4,5; foreign bacteria and anaerobes are flushed out and BV is defeated.

It is important to teach women that douching of any form is detrimental, God is fair, He created a vagina that cleanses itself and He provides all of us with water that is neutral to rinse the vagina; so that all women, rich and poor can have healthy vaginas.