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Despite a potentially higher risk of pregnant women acquiring SARS\u2010CoV\u20102 infection compared with the non\u2010pregnant population (particularly in some ethnic minorities), no additional specific recommendations to avoid exposure are needed in pregnancy. The most common clinical symptoms and laboratory signs of SARS\u2010CoV\u20102 infection in pregnancy are fever, cough, lymphopenia and elevated C\u2010reactive protein levels. Pregnancy is associated with a higher risk of severe SARS\u2010CoV\u20102 infection compared with the non\u2010pregnant population, including pneumonia, admission to the intensive care unit and death, even after adjusting for potential risk factors for severe outcomes. The risk of miscarriage does not appear to be increased in women with SARS\u2010CoV\u20102 infection. Evidence with regards to preterm birth and perinatal mortality is conflicting, but these risks are generally higher only in symptomatic, hospitalized women. The risk of vertical transmission, defined as the transmission of SARS\u2010CoV\u20102 from the mother to the fetus or the newborn, is generally low. Fetal invasive procedures are considered to be generally safe in pregnant women with SARS\u2010CoV\u20102 infection, although the evidence is still limited. In pregnant women with COVID\u201019, use of steroids should not be avoided if clinically indicated; the preferred regimen is a 2\u2010day course of dexamethasone followed by an 8\u2010day course of methylprednisolone. Non\u2010steroidal anti\u2010inflammatory drugs may be used if there are no contraindications. Hospitalized pregnant women with severe COVID\u201019 should undergo thromboprophylaxis throughout the duration of hospitalization and at least until discharge, preferably with low molecular weight heparin. Hospitalized women who have recovered from a period of serious or critical illness with COVID\u201019 should be offered a fetal growth scan about 14\u2009days after recovery from their illness. In asymptomatic or mildly symptomatic women who have tested positive for SARS\u2010CoV\u20102 infection at full term (i.e. \u2265\u200939\u2009weeks of gestation), induction of labor might be reasonable. To date, there is no clear consensus on the optimal timing of delivery for critically ill women. In women with no or few symptoms, management of labor should follow routine evidence\u2010based guidelines. Regardless of COVID\u201019 status, mothers and their infants should remain together and breastfeeding, skin\u2010to\u2010skin contact, kangaroo mother care and rooming\u2010in throughout the day and night should be practiced, while applying necessary infection prevention and control measures. Many pregnant women have already undergone vaccination, mostly in the USA where the first reports show no significant difference in pregnancy outcomes in pregnant women receiving SARS\u2010CoV\u20102 vaccination during pregnancy compared with the background risk. Vaccine\u2010generated antibodies were present in the umbilical cord blood and breast milk samples of pregnant and lactating women who received the mRNA COVID\u201019 vaccine. Based on the available limited data on the safety of the COVID\u201019 vaccine in pregnancy, it seems reasonable to offer the option of vaccination to pregnant women after accurate counseling on the potential risk of a severe course of the disease and the unknown risk of fetal exposure to the vaccine. \u00a9 2021 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>","DOI":"10.1002\/uog.23628","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T10:46:56Z","timestamp":1615891616000},"page":"687-697","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Counseling in maternal\u2013fetal medicine: <scp>SARS\u2010CoV<\/scp>\u20102 infection in pregnancy"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-3393","authenticated-orcid":false,"given":"D.","family":"Di Mascio","sequence":"first","affiliation":[{"name":"Department of Maternal and Child Health and Urological Sciences \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6880-7407","authenticated-orcid":false,"given":"D.","family":"Buca","sequence":"additional","affiliation":[{"name":"Center for High\u2010Risk Pregnancy and Fetal Care, Department of Obstetrics and Gynecology University of Chieti  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2854-0239","authenticated-orcid":false,"given":"V.","family":"Berghella","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine, Sidney Kimmel Medical College Thomas Jefferson University  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-7670","authenticated-orcid":false,"given":"A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St George's University Hospitals NHS Foundation Trust, University of London  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5525-4353","authenticated-orcid":false,"given":"G.","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Division of Maternal and Fetal Medicine, Ospedale Cristo Re University of Rome Tor Vergata  Rome Italy"},{"name":"Department of Obstetrics and Gynecology The First I.M. 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