Royal College of Obstetricians and Gynaecologists – Advice for health professionals to share with pregnant women: 2020-03-26-covid19-pregnancy-guidance.pdf

Royal College of Obstetricians and Gynaecologists – Coronavirus infection and pregnancy: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

Government guidance: https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public

 

Coronavirus Update –  Friday 27th March 2020

We understand this must be an unsettling time for all couples who are either trying to get pregnant or those who are already pregnant, in particular if you are on medications. 

We would like to emphasise that we will try to support you as much as we can and will endeavour to respond to your queries in a timely manner. We are currently working as hard as possible despite some of our staff self-isolating. It is important to note that attending antenatal and scan appointments when you are pregnant is essential to ensure the wellbeing of pregnant women and their babies, and we would urge all pregnant women who are well, to attend their care as advised by their health professionals. 

If you have symptoms of possible coronavirus infection, you should call to defer your visit until after the isolation period is over. You should also follow NHS England advise on possible coronavirus infection or exposure by clicking on the link: https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public 

For all pregnant women under 28 weeks, we strongly advise enhanced social distancing https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults 

Kindly please be advised of the following URGENT instructions from Mr Shehata:- 

Intralipid infusion 

In general, there is no particular known concerns with intralipid infusions and viruses. 

 

Pregnant women on prednisolone 

Kindly please reduce the dose of prednisolone by 1 tablet from 25mg daily to 20mg daily for 3 days then reduce further by 1 tablet to 15mg (3 tablets) and maintain on this dose as per the rest of your treatment programme. The aim of reducing the medication to a smaller dose is mainly to lower your chances of being negatively affected by the Covid-19 virus and its potential complications. It is understandable that you may be concerned about the reduced dose on the outcome of the pregnancy, but we need to balance risks vs benefits as we are in an unchartered territory. Kindly please contact the clinic via nurses@crpclinic.co.uk to inform us that you have done that or if you have any other queries. 

 

Pregnant women on hydroxychloroquine 

Kindly please reduce the dose from 400mg down to 200mg (1 tablet) and maintain on this dose as per the rest of your treatment programme. The aim of reducing the medication to a smaller dose is mainly to lower your chances of being negatively affected by the Covid-19. It is understandable that you may be concerned about the reduced dose on the outcome of the pregnancy, but we need to balance risks vs benefits as we are in an unchartered territory. Kindly please contact the clinic via nurses@crpclinic.co.uk to inform us that you have done that or if you have any other queries. 

 

Pregnant women on prednisolone and hydroxychloroquine 

Kindly please wean off the steroids by lowering the dose by 5mg (1 tablet) every 4 days till you eventually stop; in addition lower the hydroxychloroquine dose from 400mg down to 200mg and maintain on this dose as per the rest of your treatment programme. The aim of reducing the medication to a smaller dose is mainly to lower your chances of being negatively affected by the Covid-19. It is understandable that you may be concerned about the reduced dose on the outcome of the pregnancy, but we need to balance risks vs benefits as we are in an unchartered territory. Kindly please contact the clinic via nurses@crpclinic.co.uk to inform us that you have done that or if you have any other queries. 

 

Pregnant women on GCSF 

Kindly please contact the clinic via nurses@crpclinic.co.uk to discuss your medications plan. 

 

Non-pregnant women trying for pregnancy and are on prednisolone and/or hydroxychloroquine 

We advise our patients to consider halting trying for now until there is more clarity on the outbreak. Kindly please contact the clinic via nurses@crpclinic.co.uk to discuss your treatment plan if you wish to do so. 

 

Non-pregnant women trying for pregnancy without immune therapy such as superovulation programme 

We advise our patients to suspend trying. However, if you wish to continue on your treatment programme, kindly please get in touch with our clinic on nurses@crpclinic.co.uk, as the clinical situation may change with regards to offering follow up and follicle tracking appointments when required, due to the fast and ever-changing situation with the outbreak. 

 

If you have any appointment queries please contact us on office@crpclinic.co.uk and for medical queries on nurses@crpclinic.co.uk