Pregnancy and COVID-19: Physiology, some Challenges, and Solutions

COVID-19 infection is a progressive disease that is associated with a rapidly increasing in global mortality. With the prevalence of COVID-19 infection, its prevention and control among pregnant women, and the potential risk of transmission to the fetus has become a main concern. The present study, while introducing evidence for SARS and MERS in pregnant women, examines some physiological changes in this population and the possible treatment strategies.

In this review article, 147 related articles up to September 1, 2020 from the Persian and English language databases of Google, Google Scholar, Web of Science, Pubmed, and Scopus were extracted using the keywords of infection, COVID-19, pregnancy, fetus, and physiology. The articles which did not serve the purpose of this study were excluded from the study process. Finally, the information of 66 articles was used to write the present article.

Despite the lack of vertical transmission of the virus from mother to fetus during the previous outbreak of SARS-CoV and MERS-CoV coronaviruses, a case of vertical transmission of SARS-COV-2 to the placenta and fetus in late pregnancy has been reported. Changes in ACE2 receptor expression, respiratory-vascular changes, and changes in the immune system are some of the reasons for pregnant women's sensitivity to the SARS-COV-2. The management and control of COVID-19 infection include screening and intensive care, medication, and guided therapy.

Given the immunological and physiological changes during pregnancy and limited information about COVID-19 infection, pregnant women are at-risk populations and have identified as high-risk groups.