{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:30:07Z","timestamp":1792737007688,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>There are limited case series reporting the impact on women affected by coronavirus during pregnancy. In women affected by severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), the case fatality rate appears higher in those affected in pregnancy compared with non\u2010pregnant women. We conducted a rapid review to guide health policy and management of women affected by COVID\u201019 during pregnancy, which was used to develop the Royal College of Obstetricians and Gynaecologists' (RCOG) guidelines on COVID\u201019 infection in pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Searches were conducted in PubMed and MedRxiv to identify primary case reports, case series, observational studies and randomized controlled trials describing women affected by coronavirus in pregnancy. Data were extracted from relevant papers. This review has been used to develop guidelines with representatives of the Royal College of Paediatrics and Child Health (RCPCH) and RCOG who provided expert consensus on areas in which data were lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 9965 search results in PubMed and 600 in MedRxiv, 21 relevant studies, all of which were case reports or case series, were identified. From reports of 32 women to date affected by COVID\u201019 in pregnancy, delivering 30 babies (one set of twins, three ongoing pregnancies), seven (22%) were asymptomatic and two (6%) were admitted to the intensive care unit (ICU), one of whom remained on extracorporeal membrane oxygenation. No maternal deaths have been reported to date. Delivery was by Cesarean section in 27 cases and by vaginal delivery in two, and 15 (47%) delivered preterm. There was one stillbirth and one neonatal death. In 25 babies, no cases of vertical transmission were reported; 15 were reported as being tested with reverse transcription polymerase chain reaction after delivery. Case fatality rates for SARS and MERS were 15% and 27%, respectively. SARS was associated with miscarriage or intrauterine death in five cases, and fetal growth restriction was noted in two ongoing pregnancies affected by SARS in the third trimester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Serious morbidity occurred in 2\/32 women with COVID\u201019, both of whom required ICU care. Compared with SARS and MERS, COVID\u201019 appears less lethal, acknowledging the limited number of cases reported to date and that one woman remains in a critical condition. Preterm delivery affected 47% of women hospitalized with COVID\u201019, which may put considerable pressure on neonatal services if the UK's reasonable worst\u2010case scenario of 80% of the population being affected is realized. Based on this review, RCOG, in consultation with RCPCH, developed guidance for delivery and neonatal care in pregnancies affected by COVID\u201019, which recommends that delivery mode be determined primarily by obstetric indication and recommends against routine separation of affected mothers and their babies. We hope that this review will be helpful for maternity and neonatal services planning their response to COVID\u201019. \u00a9 2020 The Authors.\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.22014","type":"journal-article","created":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T04:14:16Z","timestamp":1584418456000},"page":"586-592","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":377,"title":["Coronavirus in pregnancy and delivery: rapid review"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1886-6358","authenticated-orcid":false,"given":"E.","family":"Mullins","sequence":"first","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction, Imperial College London Queen Charlotte's and Chelsea Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Evans","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust  Bristol UK"},{"name":"The Royal College of Paediatrics and Child Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. M.","family":"Viner","sequence":"additional","affiliation":[{"name":"The Royal College of Paediatrics and Child Health  London UK"},{"name":"University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust  London UK"},{"name":"The Royal College of Obstetricians and Gynaecologists  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Morris","sequence":"additional","affiliation":[{"name":"The Royal College of Obstetricians and Gynaecologists  London UK"},{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust  Norwich, Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Royal College of Obstetricians and Gynaecologists. Coronavirus (COVID\u201019) infection and pregnancy 2020.https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/coronavirus\u2010covid\u201019\u2010infection\u2010in\u2010pregnancy\u2010v3\u201020\u201003\u201018.pdf"},{"key":"e_1_2_7_3_1","first-page":"1","article-title":"Clinical characteristics and intrauterine vertical transmission potential of COVID\u201019 infection in nine pregnant women: a retrospective review of medical records","volume":"6736","author":"Chen H","year":"2020","journal-title":"Lancet"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa200"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/tp.2020.02.06"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.02.028"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1002.030736"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.075309"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.11.019"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00199.x"},{"key":"e_1_2_7_11_1","first-page":"1","article-title":"Potential Maternal and Infant Outcomes from Coronavirus 2019\u2010nCoV (SARS\u2010CoV\u20102) Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections","volume":"20","author":"Schwartz D","year":"2020","journal-title":"Viruses"},{"key":"e_1_2_7_12_1","article-title":"Infants Born to Mothers With Severe Acute Respiratory Syndrome","volume":"112","author":"Shek CC","year":"2020","journal-title":"Pediatrics"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1437-y"},{"key":"e_1_2_7_14_1","first-page":"5","article-title":"MERS\u2010CoV Infection in a Pregnant Woman in Korea","volume":"3","author":"Jeong SY","year":"2017","journal-title":"J Korean Med Sci"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw412"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.4097\/kjae.2016.69.3.287"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2203.151049"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiu068"},{"key":"e_1_2_7_19_1","first-page":"501","article-title":"Middle East Respiratory Syndrome Coronavirus (MERS\u2010CoV) infection during pregnancy: Report of two cases & review of the literature","volume":"52","author":"Alfaraj S","year":"2019","journal-title":"J Microbiol"},{"key":"e_1_2_7_20_1","first-page":"516","article-title":"Clinical analysis of pregnancy in second and third trimesters complicated severe acute respiratory syndrome","volume":"38","author":"Zhang J","year":"2003","journal-title":"Zhonghua Fu Chan Ke Za Zhi"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/00313020600696280"},{"key":"e_1_2_7_22_1","first-page":"863","article-title":"Materno\u2010fetal transmission of human coronaviruses: a prospective pilot study","volume":"2008","author":"Gagneur A","year":"2005","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000151598.49129.de"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9007"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7669"},{"key":"e_1_2_7_26_1","first-page":"1","article-title":"Working Committee on Perinatal and Neonatal Management for the Prevention and Control of the 2019 Novel Coronavirus Infection. Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition)","volume":"8","author":"Wang L","year":"2020","journal-title":"Ann Transl Med"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22013"},{"key":"e_1_2_7_28_1","unstructured":"Centers for Disease Control and Prevention. Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID\u201019) in Inpatient Obstetric Healthcare Settings 2020.https:\/\/www.cdc.gov\/coronavirus\/2019\u2010ncov\/hcp\/inpatient\u2010obstetric\u2010healthcare\u2010guidance.html"},{"key":"e_1_2_7_29_1","unstructured":"British National Formulary. Kaletra.https:\/\/bnf.nice.org.uk\/medicinal\u2010forms\/lopinavir\u2010with\u2010ritonavir.html"},{"key":"e_1_2_7_30_1","unstructured":"British National Formulary. 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