References

Ahmed I, Azhar A, Eltaweel N First COVID-19 maternal mortality in the UK associated with thrombotic complications. Br J Haematol. 2020; 190:e37-e38 https://doi.org/10.1111/bjh.16849

Brooks SK, Webster RK, Smith LE The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020; 395:912-20 https://doi.org/10.1016/S0140-6736(20)30460-8

Der Tuuk KV, Van Pampus MG, Koopmans CM Prediction of caesarean section risk in women with gestational hypertension or preeclampsia at term. Eur J Obstet Gynecol Reprod Biol. 2015; 191:23-7 https://doi.org/10.1016/j.ejogrb.2015.05.009

Ehrenberg HM, Durnwald CP, Catalano P, Mercer BM. The influence of obesity and diabetes on the risk of cesarean delivery. Am J Obstet Gynecol. 2004; 191:(3)969-974 https://doi.org/10.1016/j.ajog.2004.06.057

Gonzalez-Brown VM, Reno J, Lortz H, Fiorini K, Costantine MM. Operating Room Guide for Confirmed or Suspected COVID-19 Pregnant Patients Requiring Cesarean Delivery. Am J Perinatol. 2020; 37:(8)825-8 https://doi.org/10.1055/s-0040-1709683

Gu Y, Lu J, Li W Joint Associations of Maternal Gestational Diabetes and Hypertensive Disorders of Pregnancy with Overweight in Offspring. Front Endocrinol (Lausanne). 2019; 10 https://doi.org/10.3389/fendo.2019.00645

Guan W, Ni Z, Hu Y Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382:(18)1708-20 https://doi.org/10.1056/NEJMoa2002032

Hirshberg A, Downes K, Srinivas S. Comparing standard office-based follow-up with text-based remote monitoring in the management of postpartum hypertension: a randomised clinical trial. BMJ Qual Saf. 2018; 27:(11)871-7 https://doi.org/10.1136/bmjqs-2018-007837

Iacobucci G. Covid-19: diabetes clinicians set up social media account to help alleviate patients' fears. BMJ. 2020; 368 https://doi.org/10.1136/bmj.m1262

Liang H, Acharya G. Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow?. Acta Obstet Gynecol Scand. 2020; 99:(4)439-42 https://doi.org/10.1111/aogs.13836

Mackillop L, Hirst JE, Bartlett KJ Comparing the Efficacy of a Mobile Phone-Based Blood Glucose Management System With Standard Clinic Care in Women With Gestational Diabetes: Randomized Controlled Trial. JMIR Mhealth Uhealth. 2018; 6:(3) https://doi.org/10.2196/mhealth.9512

Monk C, Lugo-Candelas C, Trumpff C. Prenatal Developmental Origins of Future Psychopathology: Mechanisms and Pathways. Annu Rev Clin Psychol. 2019; 15:(1)317-44 https://doi.org/10.1146/annurev-clinpsy-050718-095539

Mor G, Cardenas I. The immune system in pregnancy: a unique complexity. Am J Reprod Immunol. 2010; 63:(6)425-33 https://doi.org/10.1111/j.1600-0897.2010.00836.x

Rambaldi MP, Weiner E, Mecacci F Immunomodulation and preeclampsia. Best Pract Res Clin Obstet Gynaecol. 2019; 60:87-96 https://doi.org/10.1016/j.bpobgyn.2019.06.005

Sheu A, Chan Y, Ferguson A A proinflammatory CD4(+) T cell phenotype in gestational diabetes mellitus. Diabetologia. 2018; 61:(7)1633-43 https://doi.org/10.1007/s00125-018-4615-1

Sifnaios E, Mastorakos G, Psarra K Gestational Diabetes and T-cell (Th1/Th2/Th17/Treg) Immune Profile. In Vivo. 2019; 33:(1)31-40 https://doi.org/10.21873/invivo.11435

Yang J, Zheng Y, Gou X Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis. 2020; 94:91-5 https://doi.org/10.1016/j.ijid.2020.03.017

COVID-19: women with diabetes and hypertension during pregnancy

02 November 2020
Volume 28 · Issue 11

Abstract

Midwives should be prepared to create individualised care plans, share data and liase with other departments, to improve maternal and fetal outcomes for pregnant women with these conditions

COVID-19 is a worldwide pandemic and poses a significant challenge to the care of pregnant women, especially pregnancies complicated by diabetes and hypertension. These pregnancies are associated with increased adverse pregnancy outcomes for both mother and child and require further care (Gu et al, 2019). Notably, the first maternal mortality in the UK was a woman with type 2 diabetes (Ahmed et al, 2020). A multi-disciplinary approach is critical to the provision of optimal care to these patients. All clinical staff involved in the care of these patients should receive adequate training, including in the use of personal protective equipment (PPE).

The current outbreak of COVID-19 is sweeping across the world and having a devastating impact on healthcare systems globally. Increasing evidence shows that hypertension and diabetes are among the most significant comorbidities in patients with COVID-19 and these two conditions are also associated with increased morbidity and mortality (Yang et al, 2020; Guan et al, 2020). Therefore, pregnant women with diabetes and hypertension who contract COVID-19 would be at even higher risk of adverse pregnancy outcomes. Since diabetes and hypertension (pre-existing or pregnancy-induced) are common complications in pregnancy, healthcare professionals will face extra challenges with these patients.

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