By Sarah Hannan
According to the Sri Lanka College of Obstetricians and Gynaecologists (SLCOG), on average, Sri Lanka records about 311,000 births every year, and with the present Covid-19 variants in circulation being identified to pose a risk to pregnant mothers who are at the beginning of their second trimester, special attention is to be focused on their health and wellbeing.
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Pregnant mothers and children admitted to the Covid Ward at the Infectious Diseases Hospital[/caption]
Meanwhile, the Sri Lanka College of Paediatricians (SLCP) too has warned that children are also now at high risk if they contract the virus.
The Technical Committee on Covid-19 Vaccination in the country is said to have taken into consideration the vaccination of pregnant women.
Speaking to The Sunday Morning, Disaster Preparedness and Response Division Deputy Director General of Health Services Dr. Hemantha Herath explained: “The Technical Committee on Covid-19 Vaccination is at present discussing the possibility of vaccinating pregnant mothers. They have been asked to present their findings and recommendations on the safety of vaccinating this group. Once the committee presents a report with the findings and as to which vaccination types could be safely administered, the Director General of Health Services will issue a circular on how to proceed.”
Since the Covid-19 virus started to spread last year, nearly 1,000 pregnant women have been recorded to have contracted the virus.
The SLCOG noted that among the pregnant mothers that contract Covid-19, about 80% of them had not shown symptoms during the first and second waves.
However, the variants detected in the present wave are said to induce abortions and are observed to cause complications to foetal development, especially in mothers that have passed the first 28 weeks of their pregnancy.
Therefore, the SLCOG stressed that pregnant mothers should avoid social gatherings and attending various events where crowds gather, wear facemasks, maintain physical distancing if they have to be in a public setting, wash or sanitise their hands frequently, practise respiratory etiquette, and make arrangements to work from home during their pregnancy.
Explaining the situation, Castle Street Hospital for Women Consultant in Obstetrics and Gynaecology Dr. Sanath Lanerolle, told The Sunday Morning: “Pregnant mothers are at increased risk of complications if they are infected after they have completed the first 28 weeks of their pregnancies, with the present Covid-19 variants in circulation in the country. If such mothers show symptoms of Covid-19, they should consult their area gynaecologist for a check-up and get hospitalised immediately.”
Dr. Lanerolle also noted that pregnant mothers should make regular visits to antenatal clinics in hospitals, and those who are presently residing in isolated areas should immediately notify their family health service officer if they display symptoms of Covid-19 or call the hotline on 0710 301 225 for advice. Apart from that, he also stated that the mothers should immediately see a doctor if they observe loss of foetal movement, experience bleeding, or undergo labour pains.
Present situation
Colombo East Base Hospital, Mulleriyawa Consultant in Obstetrics and Gynaecology Dr. Mayuramana Devalage explained that, according to his knowledge, a total of 903 pregnant women in the country had been infected by Covid-19.
“During the first and second waves, our hospital alone treated 250 pregnant mothers that were infected with Covid-19, out of which, 176 did not show symptoms. However, at present, the number of pregnant women that have been referred to our hospital increased to 400 within the first month since the commencement of the third wave,” Dr. Devalage noted.
During the present wave, many pregnant mothers that contract the virus have been observed to show aggravated symptoms, with some mothers suddenly finding it difficult to breathe and are required to be referred to the intensive care unit (ICU). According to Dr. Devalage, at present, six such mothers have been admitted to the ICUs, and unfortunately, one mother lost her life.
“We urge mothers to continue to follow the health guidelines provided, as the current wave is causing a surge in maternal mortality. Furthermore, we are also seeing an increase in the number of caesarean section births taking place, especially for mothers who have Covid-19,” Dr. Devalage added.
Facilities need improvement
The Colombo East Base Hospital, Mulleriyawa has currently set up a 36-bed unit to treat pregnant mothers that contract Covid-19 and the hospital has also set up a surgery unit that is decontaminated to prevent the virus from spreading.
However, the hospital reported that they lack special ICU beds dedicated to pregnant mothers.
SLCOG President and Consultant in Obstetrics and Gynaecology Dr. Pradeep De Silva, speaking to The Sunday Morning, noted: “Taking into consideration the developing risks that the virus is posing on pregnant mothers, the Government should look at increasing the number of beds from 50 to 200 for pregnant mothers in hospitals at the district level. These beds should also be supplied with 10-50 high flow oxygen units. Even the ICU beds for pregnant mothers at the district level should be allocated between four and 10.”
Dr. De Silva also reiterated that at least two dedicated extracorporeal membrane oxygenation (ECMO) machines should be allocated for the use of pregnant mothers with at least one machine installed at the Colombo East Base Hospital, which has more Covid-19-infected pregnant mothers being treated, and the other in another suitable hospital.
Safeguarding children
With the third wave of Covid-19 aggressively infecting more persons every day in the country, the SLCP and the Family Health Bureau of the Ministry of Health has cautioned that the new variant in circulation has placed children too at risk.
While children were less likely to contract Covid-19 during the previous two waves, and showed little to no symptoms when they tested positive, at present, some children are showing severe symptoms of Covid-19, which is leading to complications and even death.
The SLCP noted that children with lung diseases, heart diseases, kidney diseases, liver diseases, cancers, and other chronic diseases and with weakened immune systems are at high risk and should be safeguarded from the virus.
Many of the children contracting Covid-19 will also develop multisystem inflammatory syndrome in children (MIS-C) which can lead to multi-organ failure. While many children recover from this, in some children, it might cause death.
The SLCP and the Family Health Bureau has therefore urged parents and adults to pay attention to the following advice;
Pregnant mothers and children admitted to the Covid Ward at the Infectious Diseases Hospital[/caption]
Meanwhile, the Sri Lanka College of Paediatricians (SLCP) too has warned that children are also now at high risk if they contract the virus.
The Technical Committee on Covid-19 Vaccination in the country is said to have taken into consideration the vaccination of pregnant women.
Speaking to The Sunday Morning, Disaster Preparedness and Response Division Deputy Director General of Health Services Dr. Hemantha Herath explained: “The Technical Committee on Covid-19 Vaccination is at present discussing the possibility of vaccinating pregnant mothers. They have been asked to present their findings and recommendations on the safety of vaccinating this group. Once the committee presents a report with the findings and as to which vaccination types could be safely administered, the Director General of Health Services will issue a circular on how to proceed.”
Since the Covid-19 virus started to spread last year, nearly 1,000 pregnant women have been recorded to have contracted the virus.
The SLCOG noted that among the pregnant mothers that contract Covid-19, about 80% of them had not shown symptoms during the first and second waves.
However, the variants detected in the present wave are said to induce abortions and are observed to cause complications to foetal development, especially in mothers that have passed the first 28 weeks of their pregnancy.
Therefore, the SLCOG stressed that pregnant mothers should avoid social gatherings and attending various events where crowds gather, wear facemasks, maintain physical distancing if they have to be in a public setting, wash or sanitise their hands frequently, practise respiratory etiquette, and make arrangements to work from home during their pregnancy.
Explaining the situation, Castle Street Hospital for Women Consultant in Obstetrics and Gynaecology Dr. Sanath Lanerolle, told The Sunday Morning: “Pregnant mothers are at increased risk of complications if they are infected after they have completed the first 28 weeks of their pregnancies, with the present Covid-19 variants in circulation in the country. If such mothers show symptoms of Covid-19, they should consult their area gynaecologist for a check-up and get hospitalised immediately.”
Dr. Lanerolle also noted that pregnant mothers should make regular visits to antenatal clinics in hospitals, and those who are presently residing in isolated areas should immediately notify their family health service officer if they display symptoms of Covid-19 or call the hotline on 0710 301 225 for advice. Apart from that, he also stated that the mothers should immediately see a doctor if they observe loss of foetal movement, experience bleeding, or undergo labour pains.
Present situation
Colombo East Base Hospital, Mulleriyawa Consultant in Obstetrics and Gynaecology Dr. Mayuramana Devalage explained that, according to his knowledge, a total of 903 pregnant women in the country had been infected by Covid-19.
“During the first and second waves, our hospital alone treated 250 pregnant mothers that were infected with Covid-19, out of which, 176 did not show symptoms. However, at present, the number of pregnant women that have been referred to our hospital increased to 400 within the first month since the commencement of the third wave,” Dr. Devalage noted.
During the present wave, many pregnant mothers that contract the virus have been observed to show aggravated symptoms, with some mothers suddenly finding it difficult to breathe and are required to be referred to the intensive care unit (ICU). According to Dr. Devalage, at present, six such mothers have been admitted to the ICUs, and unfortunately, one mother lost her life.
“We urge mothers to continue to follow the health guidelines provided, as the current wave is causing a surge in maternal mortality. Furthermore, we are also seeing an increase in the number of caesarean section births taking place, especially for mothers who have Covid-19,” Dr. Devalage added.
Facilities need improvement
The Colombo East Base Hospital, Mulleriyawa has currently set up a 36-bed unit to treat pregnant mothers that contract Covid-19 and the hospital has also set up a surgery unit that is decontaminated to prevent the virus from spreading.
However, the hospital reported that they lack special ICU beds dedicated to pregnant mothers.
SLCOG President and Consultant in Obstetrics and Gynaecology Dr. Pradeep De Silva, speaking to The Sunday Morning, noted: “Taking into consideration the developing risks that the virus is posing on pregnant mothers, the Government should look at increasing the number of beds from 50 to 200 for pregnant mothers in hospitals at the district level. These beds should also be supplied with 10-50 high flow oxygen units. Even the ICU beds for pregnant mothers at the district level should be allocated between four and 10.”
Dr. De Silva also reiterated that at least two dedicated extracorporeal membrane oxygenation (ECMO) machines should be allocated for the use of pregnant mothers with at least one machine installed at the Colombo East Base Hospital, which has more Covid-19-infected pregnant mothers being treated, and the other in another suitable hospital.
Safeguarding children
With the third wave of Covid-19 aggressively infecting more persons every day in the country, the SLCP and the Family Health Bureau of the Ministry of Health has cautioned that the new variant in circulation has placed children too at risk.
While children were less likely to contract Covid-19 during the previous two waves, and showed little to no symptoms when they tested positive, at present, some children are showing severe symptoms of Covid-19, which is leading to complications and even death.
The SLCP noted that children with lung diseases, heart diseases, kidney diseases, liver diseases, cancers, and other chronic diseases and with weakened immune systems are at high risk and should be safeguarded from the virus.
Many of the children contracting Covid-19 will also develop multisystem inflammatory syndrome in children (MIS-C) which can lead to multi-organ failure. While many children recover from this, in some children, it might cause death.
The SLCP and the Family Health Bureau has therefore urged parents and adults to pay attention to the following advice;
- Set an example for your children to follow all the health guidelines
- Avoid taking children out of the house unnecessarily
- Masks are essential for every child over the age of two and keep children under the age of two away from other people and do not allow anyone to hug or kiss the child
- Train the children to wash or sanitise their hands frequently
- When coughing or sneezing, ask the child to use a tissue or the back of their elbow
- Take measures to clean and disinfect surfaces that the child comes into contact with frequently
- If the child wants to contact their friends, allow them to keep in touch with them over the phone or through online platforms
- Engage children in a variety of activities to ensure their mental wellbeing
- If there is a Covid patient or person with symptoms in the house, keep the child away from that person
- If the child develops Covid-19 symptoms, seek medical advice immediately