Since the declaration of the global pandemic of COVID-19 by the World Health Organization on 11 March 2020, we have continued to see a steady rise in the number of patients infected by SARS-CoV-2. However, there is still very limited data on the course and outcomes of this serious infection in a vulnerable population of pregnant patients and their fetuses. International perinatal societies and institutions including SMFM, ACOG, RCOG, ISUOG, CDC, CNGOF, ISS/SIEOG, and CatSalut have released guidelines for the care of these patients. We aim to summarize these current guidelines in a comprehensive review for patients, healthcare workers, and healthcare institutions. We included 15 papers from 10 societies through a literature search of direct review of society’s websites and their journal publications up till 20 April 2020. Recommendations specific to antepartum, intrapartum, and postpartum were abstracted from the publications and summarized into Tables. The summary of guidelines for the management of COVID-19 in pregnancy across different perinatal societies is fairly consistent, with some variation in the strength of recommendations. It is important to recognize that these guidelines are frequently updated, as we continue to learn more about the course and impact of COVID-19 in pregnancy.

To add to the growing evidence on SARS-CoV-2 infection during pregnancy, so as to better inform clinical decision making and optimize patient outcomes. A systematic search of relevant databases was...

To cope with the changing healthcare services in the era of SARS-CoV-2 pandemic; we share the institutional framework for the management of anomalous fetuses requiring fetal intervention at Mayo Clinic, Rochester, Minnesota. To assess the success of our program during this time, we compare intraoperative outcomes of fetal interventions performed during the pandemic, with the previous year. We implemented our testing protocol on patients undergoing fetal intervention at our institution between March 1st and May 15th 2020 and we compared to same period a year before. A total of 17 pregnant patients with anomalous fetuses who met criteria for fetal intervention were included; 8 from 2019 and 9 from 2020. Our testing protocol was designed based on our institutional perinatal guidelines, surgical requirements from Infection prevention and control (IPAC) committee and input from our fetal surgery team; with focus on urgency of procedure and maternal SARS-CoV-2 screening status. We compared the indications, types of procedures, maternal age, gestational age at procedure, type of anesthesia used and duration of procedure for cases performed at our institution between March 1st, 2020 to May 15th, 2020 and the same period in 2019. There were no statistically significant differences between the number of cases, indications, types of procedures, maternal age, gestational age, types of anesthesia and duration of procedures (p values were all > 0.05) between pre-SARS-CoV-2 pandemic in 2019 and SARS-CoV-2 pandemic in 2020. Adoption of new institutional protocols during SARS-CoV-2 pandemic, with appropriate screening and case selection, allows provision of necessary fetal intervention with maximum benefit to mother, fetus and health care provider.

Background: The emergence of a novel coronavirus (SARS-CoV-2) has had the world on high alert since December 2019. Pregnancy is associated with various physiological changes that predispose this subset of patients to severe respiratory infections. Although no maternal deaths related to SARS-CoV-2 have been reported at this time, it has been suggested that it may follow a similar pattern to SARS and MERS. Methods: We conducted a systematic review on March 25, 2020 and a repeat PUBMed search on April 10, 2020. Studies evaluating pregnant patients with SARS-CoV-2 infection at any time during their pregnancy were included. Due to scarcity of available data, the authors chose to include as many studies as fitted the criteria. Findings: The initial electronic literature search yielded 84 results. We reviewed 16 articles with a total of 155 pregnant patients and 118 perinatal outcomes described. Evidence proposes a similar rate of severe cases of SARS-CoV-2 in pregnant women and the general population. Even with guidelines advising against C-section in infected patients, the frequency of cesarean deliveries is high. Studies have suggested lack of vertical transmission, but a recent report has shown the presence of IgM antibodies in a newborn. Interpretation: The limited data on the clinical course, maternal and perinatal outcomes of COVID-19 in pregnancy associated with a wide variation in the methodology makes accurate data interpretation difficult. This review will add to the growing body of evidence on the topic to better inform decision making and optimize patient outcomes. Funding Statement: None. Declaration of Interests: The authors declare no competing interests.