Covid 19 and pregnancy: what you need to know

Covid 19 is a viral disease that has claimed a lot of lives in the world. Young men and women including our parents who are immunocompromised also lost their lives during the outbreak of this disease. This virus hardly leaves you alive if in one way or the other you are suffering from chronic disease which may alter the level of your immune system. Take for instance people that are having chronic lung issue like asthma or people living with HIV. This set of people finds it difficult to survive this diseases because of their incapacitated antibody, injury of lungs and many other factors.

This is also applicable to pregnant women who actually contracted this virus. Women who are pregnant always come down with difficulty in breathing. This is as a result of the effect of the growing uterus on the diaphragm by reducing the lung capacity. This explanation may not be clear enough, but we will detail more on that as we go further.

In August 2021 statistics review to us that among 870,000 pregnant women who have visited 500 medical center in US between 1st March 2020 to 28 February 2021 for child delivery. Those who are diagnose of covid 19 were 15 times more likely to die than those who are not diagnose of the disease.source

By now many questions may be going through your mind on how this covid 19 can be dangerous to pregnant woman. But well, we will go down to put in details the respiratory physiology of a pregnant mother and why covid 19 can be detrimental.

Respiratory physiology of pregnancy

Whenever a woman gets pregnant a lot of factors comes into play. At first you notice signs of weekness all over the persons body. At times it normally comes with dizziness and a swollen breast.

At some point you will start noticing some changes in the pulmonary function and the ventilatory pattern which indicates changes in the persons breathing. Changes in the hormonal patterns is the major cause of respiratory defect in pregnant mother.

Hormones which are involved in this changes includes progesterone, oestrogen and prostaglandins.

When pregnant, progesterone increases gradually from 25ng.ml-1 at 6 weeks to 150ng.ml-1 at 37 weeks. It does this by triggering the primary respiratory center through increasing the respiratory center to carbon dioxide. Progesterone also changes the smooth muscle tone of the respiratory airway causing bronchodilator effect. It mediation in hyperaemia is the major factor that causes nasal congestion.

Coming to oestrogen. This is another hormone that also plays a crucial role during pregnancy. It works as a mediator of progesterone receptors by increasing the number of progesterone receptors in the hypothalamus while prostaglandins helps to stimulate the uterine smooth muscle during labour and are always present through out the three trimester of the pregnancy.

But remember, uterine distention is
the major reason why we have lung volume and chest wall changes during pregnancy. This distension of the uterine cavity increases the end expiratory abdominal pressure. This happens by displacing the diaphragm in an upward manner. The negative pleural pressure increases therefore leading to reduction in functional residual capacity.

Getting to know the risk factors pregnancy can actually pose on our breathing rate. You can now analyse what that might actually happen if paradventure if a pregnant mother gets infected with this respiratory disease called covid 19.

SARS-CoV-2 which is actually the virus that cause covid 19 has a very severe damage to the lungs when it enters the body. It first gets in contact with the mucous membrane that governs your nose, eyes and mouth. Then it goes straight to the upper and lower respiratory tract causing irritation and inflammation. As the inflammation is getting worse your lungs are then being filled with fluid and a lot of debris.

Then consider a condition where a pregnant mother who is battling with difficulty in breathing comes down with covid 19. This will actually be devastating as the both condition can lead to severe damages to the lungs. But before we go further let's quickly glance through this 👇

Yalda Afshar was about two months pregnant when reports of COVID-19 began to emerge in the United States in February last year. As an obstetrician managing high-risk pregnancies at the University of California, Los Angeles, Afshar knew that respiratory viruses are especially dangerous to pregnant women. There was very little data on the effects of the SARS-CoV-2 virus and, as cases racked up, she felt like she was flying blind, both while advising her patients and in navigating her own worries about contracting the virus and passing it on to her baby and family. But her situation also brought her closer to the women she was treating. “I had this sense of solidarity that I’ve not felt before,” she says. “It was an inspiration to just work harder and try to get answers faster.”source

If you look at this statement by Yalda Afshar, it was actually obvious that she understoods the risk factor associated with a patient who is pregnant coming down with this virus. Though she was scared about her getting the virus and getting to spread it to her family. But she encouraged herself to work more harder to make sure things are being done to cutail the ravaging virus.

Today, despite the rate at which this virus kills pregnant mother people are still much scared in taking the vaccine not minding what the disease can cause. Reason being that the so called vaccine could be detrimental to their lives and the lives of their unborn child.

In the part of Nigeria where I come from, there is a whole lot of women who are pregnant. But then, there is still this phobia we all have concerning this vaccine. People are scared of getting immunized to avoid any related complications that may arise subsequently as a result of the vaccination. But my question now is trying to avoid getting vaccinated to die off with this virus and getting vaccinated with hope of facing the consequences (if any)tomorrow. Which one could be more better in standing in the chances of not endangering yourself in future.

in conclusion

Since we all have noticed the implications that comes along with people who are immunocompromised that have this virus. And the rate at which this virus kills even to those that are healthy. I suggest we all should have a rethink on the way forward towards handling this issues more especially to those of us who are living in a country where everybody cares less about this virus.