One of my patients – very gently – chastised me today for not providing a recent Coronavirus update. She knows who she is.
Anyway, here goes. I have some good news, some bad news and some retractions.
The Good News
We have been drilling. Man, have we been drilling? We are so well drilled we are like the US Marines drilling during the opening credits of the Tom Cruise movie “A Few Good Men” (“You want the truth??…You can’t handle the truth!!”).
We have been drilling getting in and out of our Personal Protective Equipment (PPE) – the technical term for these activities being ‘donning’ and ‘doffing’. We have been drilling doing emergency Caesars – and dealing with other emergencies – on Covid positive women and we have been working very hard on developing what we call Clinical Guidelines for the care of all women who may have been exposed to Coronavirus. We are drilled.
For the past week POWP has been checking everyone – everyone – who comes into the hospital by asking the usual questions and checking our temperatures. The Royal Hospital for Women (RHW) is close behind.
We still believe that the significant majority of pregnant women who contract Coronavirus only suffer a mild illness. And in the absence of an unwell mother we do not believe there are increased complications for babies during pregnancy (e.g. premature birth).
Other good news is that – in Australia at least – maybe (just maybe) the curve is flattening so once more we may be called The Lucky Country. Obviously, things are terrible in continental Europe, The UK and the US. I hold grave fears for Indonesia too.
The Bad News
Contrary to my previous reports – and what was generally thought internationally – there have now been cases reported in which it seems that Coronavirus does cross the placenta. Babies have now been born with strong evidence of transplacental passage of the virus. However – and pay attention – the babies so affected have been born completely healthy.
This does mean that if you are positive for Coronavirus (or suspected of being so) your baby may be tested for evidence of the virus at birth, particularly if it is unwell in any way.
More bad news is that the draconian approaches we have taken regarding visitors (including, in some instances, your partners) still stand.
Contrary to my previous advice:
- Prince of Wales Private Hospital will be accepting Covid positive women so if you are affected (or suspected) you can still give birth at POWP. We are drilled.
- We will not be strongly advising caesareans for Covid positive women. You can give birth according to your wishes and obstetric needs. However, the situation we really wish to avoid is a major urgent rush down to theatre and giving you a General Anaesthetic for any reason because this is really risky for anaesthetists (and you) – even though we are thoroughly drilled for this eventuality. Totally drilled. Accordingly we are quite keen on epidurals in Covid positive women. This is particularly so because we don’t wish Covid positive women to use the Nitrous Oxide / Entonox (“the gas”) for pain relief because of the theoretical risk doing so can spread the virus around the room.
- The clever Australasian Paediatric professional bodies currently do not mandate separating Covid positive mums from their babies (as long as the kid is well) and breastfeeding is encouraged.
Look I think that’s about it just for now (I will have forgotten something for sure). It’s Friday night and now my weekend off. Dr Natalie Shaw is covering. We’ve ordered delivery dinner (I’m sick of cooking) and Sue is having Zoom drinks with her work colleagues. I might join them.