Health chiefs warn over potential stillbirth link to Covid-19 in four cases, investigating possible link with Covid placentitis

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Obstetricians have been asked to be on alert following four stillbirths in pregnant women infected with Covid-19 which could potentially be linked to the virus.

Investigations are needed to determine if the stillbirths are due to a condition known as Covid placentitis, a rare complication which has been seen internationally.

However, senior doctors last night urged caution in drawing conclusions about the link in these cases with Covid-19 and stressed that coroners have not concluded their findings in the cases.

Dr Cliona Murphy, chair of the Institute of Obstetricians and Gynaecologists said last night the cases are being scientifically investigated.

“It is important that pregnant women who have Covid-positive results attend for appointments with their healthcare providers in the weeks after their infection,” she said.

“The vast majority of pregnant women who had Covid have had mild symptoms and have not had adverse outcomes. Large scale surveillance data in the UK have not shown a higher incidence of stillbirth.”

She said pregnant women in priority groups can get the Covid-19 vaccine and data on vaccination in pregnancy is reassuring. The impact of vaccines and restrictions are reducing the levels of virus which will be protective for pregnant women, she added.

Deputy chief medical officer Dr Ronan Glynn, who highlighted the cases, said: “We have been made aware of four preliminary reports of stillbirths potentially associated with a condition called Covid placentitis.

“These reports should be interpreted with caution as the coroners have not yet concluded their findings.

“The HSE’s National Women and Infants Programme is aware of and is monitoring the situation and has issued a related notice to obstetric departments.

Dr Glynn said that we know from international data that this is a very rare condition.

“We have not seen high incidence of it internationally and we would not expect to see high incidence of it here,” he added.

Dr Peter McKenna of the National Women and Infants Health Programme said the experience of pregnancy and Covid-19 here has been very reassuring. Cases are not necessarily in keeping with international experience.

“There may be an explanation for these four findings. They may be associated with a stillbirth rather than a cause of it,” he said.

The cases came to light after following post-mortem results involving two coroners who reported them to the HSE. They found inflammation in the placenta in each case.

The stillbirths are believed to have happened the first two months of the year and the women, whose virus was confirmed, suffered mild to moderate symptoms.

Obstetricians are expected to monitor pregnant women more as a precaution.

Asked to comment on the reports, obstetrician Professor Michael Turner of the Coombe Hospital and UCD said: “I would urge caution about these cases. The last thing we want to do is generate anxiety for women who are currently pregnant and have not been vaccinated.”

He said that one of the challenges in pregnancy is that you can have immune modulation which makes women more vulnerable to infections

“We need to be very cautious about over interpreting preliminary findings,” he said.

“It highlights the need for us to remain vigilant during pregnancy and for women if they have any concerns about the baby’s movements to go to the maternity hospital and not be put off attending because Covid-19.”

He said maternity hospitals have been very strict around Covid-19 and the number of infections have been low with most the outcomes successful.

“We don’t know if the timing of infection is important or not. You would expect women who got infected in the first third of pregnancy would be at higher risk,” Prof Turner said.

Irish Independent

Source: Irish News