I just tested positive for COVID-19 and I’m pregnant! Now WHAT?!?!

With rising COVID19 cases in New Hampshire, we are getting calls daily from our patients reporting a positive COVID-19 test.  We are here to support you with the latest information about pregnancy and COVID19.  We know that you are worried and have lot’s of questions.  We are updating this information as new guidance becomes available.

If you think you may have symptoms of COVID19, you should be tested.  Symptoms include: cough, fever, shortness of breath, headache, cold-like symptoms, sore throat, or loss or change to your sense of smell or taste.  There are many options for testing including at-home test kits (only should be done if you are symptomatic), state test sites, and pharmacies.  For a full list of testing sites, click here.  New Hampshire is also offering free COVID19 test kits.  To get your test kit, follow this link.

If you test positive for COVID-19, please call us during office hours at 603-668-8400 to let us know.  For the safety of our patients and team members, your next visit will be scheduled at least 10 days from the date of your positive test.  We are also happy to convert your scheduled visit to a telehealth visit to check-in with you.  You should isolate from others and stay at home for 10 days.  If you live with unvaccinated family members, try to isolate yourself from them.  If you are unable to isolate yourself, those family members also need to quarantine – they will need to quarantine for 20 days.  If you do need to leave your house for medical care, please be sure to wear a mask and call your healthcare provider before you arrive to notify them of your positive COVID-19 test result.

Most cases of COVID-19 are mild and can be managed at home with getting plenty of fluids and rest, as well as using medication to reduce a fever.  It is safe to treat a fever in pregnancy with Tylenol (Acetaminophen) 1000mg every eight hours.  In addition, make sure you’re staying hydrated by drinking a lot of water.  If you are fully vaccinated for COVID-19, your risk of severe illness is significantly less than those who are not vaccinated.

Primary care providers are well versed in the symptoms of COVID-19 and recommendations for treatment.  We would encourage you to reach out to your primary care provider for additional recommendations.  Because pregnancy is considered to be a high risk condition for COVID-19, your primary care provider may recommend that you receive monoclonal antibodies.  Monoclonal antibody treatments are recommended by the Centers for Disease Control (CDC) and the American College of Obstetricians and Gynecologists (ACOG) for treatment of pregnant people with mild to moderate COVID-19 who are at risk for complications from COVID-19.  There is a limited supply of monoclonal antibodies so we are relying on insight from your primary care provider as to whether you should receive monoclonal antibodies based on your symptoms.  Although monoclonal antibodies have not been specifically evaluated in pregnancy, preliminary data suggests that monoclonal antibody treatment is safe in pregnancy.  Orders for monoclonal antibodies need to come from your primary care provider.

If you feel like your symptoms are worsening, please reach out to your primary care provider for additional recommendations.  Watch for emergency warning signs for COVID-19 which may indicate more severe illness including difficulty breathing, confusion, persistent pain or pressure in the chest, or pale, gray, or blue-colored skin, lips or nail beds.  If you have any of these signs, seek emergency medical care immediately.

According to the data available from the CDC and ACOG, people with COVID-19 during pregnancy are more likely to experience preterm birth (delivering the baby earlier than 37 weeks) and stillbirth and might be more likely to have other pregnancy complications compared to people without COVID-19 during pregnancy.  Unfortunately, there are not any specific ways to prevent these risks once someone tests positive for COVID-19 other than monitoring for symptoms.  Due to a risk of pre-eclampsia (high blood pressures in pregnancy), you should begin taking low dose aspirin (81mg) daily starting at 12 weeks of pregnancy, if you have not already been instructed to take aspirin.  Once you are fully recovered from COVID-19 and at least 14 days have passed since your positive test, we will plan an ultrasound in our office to measure your baby’s growth and amniotic fluid volume after 32 weeks of pregnancy.  In addition, if you were hospitalized with COVID-19, we will schedule non-stress tests to monitor your baby’s well-being twice weekly starting at 32 weeks (and at least 14 days after you were diagnosed with COVID-19).  Please reach out to our office with any symptoms of preterm labor which include: Regular, frequent contractions or tightening of your belly, leaking fluid like your water might have broke, worsening lower back pain, and a sensation of significant lower pelvic pressure.

Current visitor guidelines at Elliot hospital on labor and delivery and maternity units is that you may have one, asymptomatic/COVID-19 negative support person at delivery.  If your support person is positive for COVID-19 or has COVID-19 symptoms, they will not be able to accompany you to L&D.

If you have not already received your COVID-19 vaccine or booster, once you are feeling better and it’s been at least 14 days since you were diagnosed with COVID-19, please get vaccinated.  Even if you have already had COVID-19, vaccination is still the best way to protect you and your baby.  

We hope you feel better soon.  Again, please be sure to seek emergency medical help if you are having any severe symptoms of COVID-19.

For more information, please visit: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html