Posted: 8/17/2020
Providers stress need for pregnant women to protect themselves from COVID-19
A baby girl born prematurely at Parkland Memorial Hospital in May who tested positive for SARS-coV-2 (COVID-19) infection at birth is believed to be one of the first known cases of intrauterine (in the womb) transmission of the disease in the U.S. and the first in Texas, Parkland providers say. The case study authored by Julide Sisman, MD and other UT Southwestern Medical Center physicians who attended the mother and baby at Parkland was published in The Pediatric Infectious Disease Journal online on July 10, 2020.
“The infant was born preterm and was separated from the mother immediately, but turned positive at 24 hours and was later symptomatic for COVID-19. The placenta from the mother had evidence of COVID-19 infection on microscopy, different staining techniques and electron microscopy, which suggests that this infant got infected from the mother in the womb,” said Mambarambath Jaleel, MD, Medical Director of the Neonatal Intensive Care Unit (NICU) at Parkland and Associate Professor of Pediatrics at UT Southwestern Medical Center, one of the study’s authors.
The infant initially appeared healthy but on the second day of life developed fever and mild respiratory problems. She tested positive for COVID-19 and was treated with supplemental oxygen, but not mechanical ventilation, for several days while in Parkland’s NICU. At 21 days, both the mother and infant were discharged in good condition from Parkland.
According to Marjorie Quint-Bouzid, MPA, RN, NEA- BC, Senior Vice President of Nursing for Women & Infants Specialty Health at Parkland, “As of August 17, more than 170 infants born to COVID-19 positive mothers have been delivered at Parkland. Of these infants, five have tested positive after birth. The majority of infants delivered to pregnant women diagnosed with COVID-19 were born without respiratory illness.”
One of these is the healthy baby boy born on July 22 at Parkland to Yuri Matamoros, 28, of Dallas. After delivery, her son tested negative for COVID-19 although his mother was hospitalized with the disease just a few weeks earlier. She, her husband and their 4-year-old son share a home with an aunt, a cousin and her cousin’s baby. Her husband and aunt also contracted COVID-19 but the other family members in the home, thankfully, did not.
“It's hard to say where I was exposed to COVID because I tried my best to never leave the house to protect myself, my baby and my family,” Matamoros said. “I still remember the day very well, July 1st. I had a headache, a fever, cough, my back was hurting and it was hard to walk. I called the hospital and was told to come in. That's when I found out I tested positive for COVID-19. There is no proper way to explain what I went through. It was hard," she said. "My husband and I were very worried for our baby."
Parkland physicians caring for her celebrated the happy outcome for Matamoros and her baby, named Jesus.
“This young mother was critically ill with COVID in the third trimester of pregnancy only a few weeks ago. She was cared for by a team including high-risk obstetricians, critical care and infectious disease specialists, specialty trained direct care nurses and respiratory therapists. She fortunately recovered and was discharged, and recently returned to Parkland to deliver a healthy newborn who was able to room in with her before they were discharged home. It’s a real success story, which we need these days,” said Emily Adhikari, MD, Medical Director of Perinatal Infectious Diseases at Parkland and Assistant Professor in the Division of Maternal-Fetal Medicine at UT Southwestern Medical Center.
Dr. Adhikari stressed the importance of women protecting themselves and their babies during pregnancy and after.
“We provide education to all pregnant women receiving care at Parkland to alert them of the potential increased risk to mothers and infants for severe illness from COVID-19. It’s very important for pregnant women to continue receiving prenatal care from their providers while also limiting their interactions with other people to avoid exposure,” she said.
Parkland instituted numerous protocols at the beginning of the COVID-19 pandemic to protect pregnant women, new mothers and their babies. These are some of the changes to Labor and Delivery processes at Parkland:
• All staff, patients and visitors have to wear masks. There are temperature screens. Patients are asked about symptoms or recent diagnoses prior to admission to Labor and Delivery.
• All women admitted to Parkland’s Labor and Delivery unit are tested for COVID-19, whether they are symptomatic or asymptomatic.
• The number of people who come into the hospital to visit is strictly limited for safety reasons.
For those providing care to hospitalized pregnant women who have the virus, Quint-Bouzid said, “We make sure that our staff is protected with all necessary personal protective equipment, but also that we limit the number of people who go into and out of patient rooms to minimize the risk of increased exposures.”
To read the article titled “Intrauterine transmission of SARS-COV-2 infection in a preterm infant,” go to https://journals.lww.com/pidj/Abstract/9000/INTRAUTERINE_TRANSMISSION_OF_SARS_COV_2_INFECTION.96099.aspx.
Safety information for women who are pregnant, breastfeeding or caring for young children is available from The Centers for Disease Control and Prevention at www.cdc.gov. To learn more about Parkland services, visit www.parklandhospital.com