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Antenatal corticosteroids may be used routinely for fetal lung maturation between 24 and 34\u2009weeks' gestation, but decisions in those with critical illness and those &lt;\u200924 or &gt;\u200934\u2009weeks' gestation should be made on a case\u2010by\u2010case basis. Magnesium sulfate may be used for seizure prophylaxis and fetal neuroprotection, albeit cautiously in those with hypoxia and renal compromise. There are no contraindications to using low\u2010dose aspirin to prevent placenta\u2010mediated pregnancy complications when indicated. An algorithm for thromboprophylaxis in pregnant patients with COVID\u201019 is presented, which considers disease severity, timing of delivery in relation to disease onset, inpatient <jats:italic>vs<\/jats:italic> outpatient status, underlying comorbidities and contraindications to the use of anticoagulation. Nitrous oxide may be administered for labor analgesia while using appropriate personal protective equipment. Intravenous remifentanil patient\u2010controlled analgesia should be used with caution in patients with respiratory depression. Liberal use of neuraxial labor analgesia may reduce the need for emergency general anesthesia which results in aerosolization. Short courses of non\u2010steroidal anti\u2010inflammatory drugs can be administered for postpartum analgesia, but opioids should be used with caution due to the risk of respiratory depression. For mechanically ventilated pregnant patients, neuromuscular blockade should be used for the shortest duration possible and reversal agents should be available on hand if delivery is imminent. To date, dexamethasone is the only proven and recommended experimental treatment for pregnant patients with COVID\u201019 who are mechanically ventilated or who require supplemental oxygen. Although hydroxycholoroquine, lopinavir\/ritonavir and remdesivir may be used during pregnancy and lactation within the context of clinical trials, data from non\u2010pregnant populations have not shown benefit. The role of monoclonal antibodies (tocilizumab), immunomodulators (tacrolimus), interferon, inhaled nitric oxide and convalescent plasma in pregnancy and lactation needs further evaluation. \u00a9 2020 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>","DOI":"10.1002\/uog.23116","type":"journal-article","created":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T05:33:26Z","timestamp":1600752806000},"page":"195-203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Pregnancy and <scp>COVID<\/scp>\u201019: pharmacologic considerations"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4049-2017","authenticated-orcid":false,"given":"R.","family":"D'Souza","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital, University of Toronto  Toronto Canada"},{"name":"Lunenfeld\u2010Tanenbaum Research Institute  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Rowe","sequence":"additional","affiliation":[{"name":"Neonatal and Pediatric Pharmacy Surrey Memorial Hospital, Fraser Health  Surrey Canada"},{"name":"Faculty of Pharmaceutical Sciences University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Zipursky","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology and Toxicology, Department of Medicine, Sunnybrook Health Sciences Centre University of Toronto  Toronto Canada"},{"name":"Institute of Health Policy, Management, and Evaluation University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Clarfield","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics &amp; Gynaecology Mount Sinai Hospital, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Arzola","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Mount Sinai Hospital, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lapinsky","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Paquette","sequence":"additional","affiliation":[{"name":"Division of Neonatology Montreal Children's Hospital  Montreal Canada"},{"name":"Department of Pediatrics McGill University  Montreal Canada"},{"name":"Research Institute of the McGill University Health Centre  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Murthy","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Paediatrics University of British Columbia  Vancouver Canada"},{"name":"BC\u2009Children's Hospital and Sunny Hill Health Centre  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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