ACOG SMI & NYSDOH NYSPQC Webinar: Managing COVID-19+ Pregnant Patients - Shared screen with speaker view
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Message From Erum Azhar:would it be more benefits of passive antibodies to newborn if pregnant women are vaccinated in 3rd trimester ?
What about the pregnant patient who is exposed or positive for covid after the first vaccine but before the second? What are our recommendations?
I unfortunately got COVID at 26 weeks pregnant. I am now 28 weeks... do you still recommend I receive the vaccine?
For exposure between the two doses: The CDC is currently recommending that people continue their schedule even if exposed between the doses.
Here is the link to the latest - 3/25 - guidance on support persons in labor & delivery: https://coronavirus.health.ny.gov/system/files/documents/2021/03/hospital-visitation-3-25-2021.pdf
For L&D admit and patient previously COVID+ within past 90 days are you just requiring they provide proof of date of COVID+?
are there any guidelines re: should the 2 accompanying persons only stay on L&D, or can they go outside (eg get lunch, etc). What about Post Partum, can 2 persons also be there or does one of the 2 persons have to eave after the delivery. What about the guideline sfor antepartum patients who may stay awhile
Camille Clare (she/her/hers)
we tend to have the support persons remain with patients on labor and delivery and an individual approach for antepartum patients admitted to the hospital
Re: support person discussion, here is the actual language from the latest DOH advisory: In addition, hospitals will ensure that following allowances are made:• Labor and Deliveryo Two support persons, including a doula if requested, may accompany the patientthroughout labor, delivery, and the postpartum period, including recovery, until dischargeto home. The support persons can be the patient’s spouse, partner, sibling, parent, orother persons of their choice.
This is the wording in the newer document...In addition, hospitals will ensure that following allowances are made:• Labor and Deliveryo Twosupportpersons,includingadoulaifrequested,mayaccompanythepatient throughout labor, delivery, and the postpartum period, including recovery, until discharge to home. The support persons can be the patient’s spouse, partner, sibling, parent, or other persons of their choice.
Is this document from the NYSDOH ?Can you include reference or link ?
Will we be getting a handout of the slides?
The slides & a recording of this webinar will be sent out via listserv to attendees.
thanks for that recording
What would your recommendation be for women in their late third trimester that are questioning whether to wait just a few more weeks until after delivery to get vaccinated? Is there any data on whether it's preferable to be vaccinated in the last weeks of pregnancy versus immediately postpartum?
There are not data on pregnancy vs. postpartum, however, there is some early data that passive immunity through transplacental antibody cross, as well as in the breastmilk, so that vaccination in pregnancy may be beneficial.
We don’t have data to address late pregnancy vs postpartum. Up until recently we were in an interesting dilemma where persons were vaccine eligible in pregnancy but not postpartum. This is now shifting. Again I think it would be a risk benefit discussion with the particular patient’s context.
Camille Clare (she/her/hers)
it is addressing the why that people are hesitant which is been helpful to the discussion
historical reasons also
How would you address fear of potential longer term effects?
Message from Erum Azhar:case report of “Newborn Antibodies to SARS-CoV-2 detected in cord blood after maternal vaccination” shows passive antibodies when mom vaccinated
case report of “Newborn Antibodies to SARS-CoV-2 detected in cord blood after maternal vaccination” show passive antibodies when mom is avccinated
I believe the context is a belief that the risks to the baby would be lesser for a woman vaccinated during lactation as opposed to during pregnancy - if the antibody benefits are present in both scenarios
I think we have to be transparent that we don’t have long term data. However, the long term implications of COVID infection are becoming clearer and clearer. We also need to think about biologic plausibility for long term effects of these vaccines.
Isn’t it true that the hesitancy exists more with white republican males? Do we have the data of BIPOC hesitancy?
We need to remember that not all women will breastfeed…that’s why it is a conversation with the patient