- COVID-19 stands for coronavirus disease of 2019
- Caused by the SARS-CoV-2 virus, a novel strain of coronavirus that causes severe acute respiratory syndrome (SARS).
- The disease was first described in Wuhan China in December 2019.
- Described as a pandemic in March 2020 by WHO
Management of infants of mothers with suspected or confirmed COVID-19 infection
- When consult for delivery is received for a confirmed or suspected COVID-19 pregnant woman, the most senior doctor should be notified.
- Universal precautions should be practiced at all times
- Number of people in the delivery room should be limited to the barest minimum
- All health workers that attend the delivery must wear full PPE
- At delivery, provide routine delivery room care: dry, stimulate and keep warm with mother in skin-to-skin contact. Ensure mother completes hand hygiene and if she is symptomatic, she should also wear a mask.
- Provide routine newborn care
- Neonatal resuscitation should be undertaken when indicated – resuscitation should be performed either in a separate room or in the delivery room, with the resuscitation area at least 2 metres from the mother.
- Avoid procedures that can result in aerosolization and perform these only when ABSOLUTELY necessary. Such procedures include suctioning, manual ventilation, intubation, noninvasive positive-pressure ventilation, cardiopulmonary resuscitation, connecting/disconnecting a patient to or from a ventilator.
COVID-19 testing in newborns
- At birth, all exposed babies should have samples for COVID-19 taken from skin surface/umbilical swabs or the amniotic fluid. Blood, urine or stool samples should also be collected and send for testing though yield for COVID-19 is said not to be high compared to nasopharyngeal swabs
- Testing of nasopharyngeal swabs should be done after 24 h of life as yield is better
Admission and further management
- Routine isolation of exposed infants from the mother is not recommended
- All COVID-19 exposed infants requiring admission should be admitted into the designated isolation ward.
- Babies with positive results who are symptomatic should be transferred to the designated neonatal ward for COVID-19 patients.
- These isolation units should have separate doctors, nurses and other support staff who have been trained and must wear full PPE while in the units
- Universal precautions must be followed at all times
- Subsequent care should be provided for all infants as indicated for co-morbidities
