Why is addressing infertility important?

Infertility is the inability to conceive after a year of trying or the inability to carry a pregnancy to term. Addressing infertility is important for several reasons:

  1. Fertility is an important part of reproductive health: Infertility can affect a person’s physical and mental health and can be a source of stress, anxiety, and depression. Addressing fertility issues can help improve overall reproductive health and well-being.
  2. It can improve the chances of having a successful pregnancy: There are various treatment options available for couples experiencing fertility issues, and addressing the underlying cause of infertility can increase the chances of having a successful pregnancy.
  3. It can help couples achieve their family-building goals: For many couples, starting a family is an important aspect of their lives. Addressing fertility issues can help couples achieve their goals of having children and building their families.
  4. It can help couples make informed decisions: Understanding the underlying cause of infertility can help couples make informed decisions about their treatment options and the potential risks and benefits of each option.

It is important for couples experiencing fertility issues to seek medical advice and support in order to address these issues and improve their chances of having a successful pregnancy.

DISCLAIMER: The information provided in here is for general educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for any questions you may have regarding a medical condition. Do not rely on the information provided here for decision-making or self-treatment. If you are experiencing a medical emergency, seek immediate medical attention.

Bio-Insights- Oocyte Morphological features

Smooth Endoplasmic Reticulum (SER) role in oocyte

SER’s are translucent vacuoles observed occasionally during ICSI in the cytoplasm of the egg. [2] testing

The endoplasmic reticulum (ER) is a network of membranes found throughout the cell and connected to the nucleus. ER functions as a manufacturing and packaging system to make products such as hormones and lipids. [2]

There are two types of ER, Rough ER, and Smooth ER

SER’s are easily distinguishable from fluid-filled vacuoles because they are not separated from the rest of the ooplasmic volume by a membrane, and are seen as translucent vacuoles. [3]

SER helps in steroid hormones and fat metabolism and production. It is smooth due to association with smooth slippery fats and is not studded with ribosomes. SER ‘s pivotal role is to store and release calcium, which will affect the calcium balance in SER-positive oocytes. .[2]

The mechanism of formation of SER’s are due to some functional and structural alterations of the SER during oocyte maturation, such as the increase in the sensitivity of the IP3 receptor for calcium, increase storage of calcium that is released during oscillation. In human oocytes, the localization of mobilizable calcium ions was detected in the small vesicles beneath the plasma membrane of SER. [3]

According to transmission electron microscopic analysis, there are three forms of SER’s, large (18 µM); medium (10-17 µM) which can be classified by light microscopy and small (2-9 µM) which are not visible under clinical embryology laboratory conditions. [3]

Oocytes consist of SER due to the presence of high estradiol level. In many cases, serum estradiol levels on the day of hCG administration were significantly higher in SER-positive cycles. [2]

It has been observed that the occurrence of SER’s is significantly related with longer duration and higher dosage of the stimulation. [3]

Pregnancies in women with affected gametes were accompanied by a higher obstetric problem leading to non-significant trends towards earlier delivery and significantly reduced birth weights. It is strongly recommended to avoid the transfer of embryos/blastocysts derived from SER-cluster positive gametes. It is known that even transfer of sibling oocytes without these anomalies involves high risk and detrimental outcome.

It is showed that the results of transfer of SER-positive embryos results in a high rate of miscarriage and the women tend to deliver earlier at 36.4 weeks of gestation which leads to lower birth rate 

References:

  1. https://www.rbmojournal.com/article/S1472-6483(10)60563-9/pdf
  2. https://www.slideshare.net/malpani/eggs-showing-smooth-endoplasmic-reticulum-clusters-produce-outcomes-similar-to-normal-eggs
  3. https://books.google.co.in/books?id=Kp5_AwAAQBAJ&pg=PA83&lpg=PA83&dq=refractile+bodies+in+oocyte&source=bl&ots=VCxnK7vkwu&sig=Akh6mi0lSgdMs36GtIulV5Zrgfo&hl=en&sa=X&ved=0ahUKEwi5mrDgspvcAhXIT30KHZkqAtI4ChDoAQhMMAc#v=onepage&q=refractile%20bodies%20in%20oocyte&f=false

Vacuoles role in oocyte

One of the most common oocyte dysmorphism is cytoplasmic vacuolization. Vacuoles are membrane-bound cytoplasmic inclusions filled with fluid that is virtually identical with perivitelline fluid. They vary in size as well as in number. They arise spontaneously or by fusion of preexisting vesicles derived from Golgi apparatus/SER. [1]

It has been shown that vacuolized oocytes have significantly reduced fertilization rates and developmental ability. Vacuoles of size 5-10 µM in diameter don’t show any biological consequences. A vacuole >14 µM in diameter can completely block fertilization. Single or multiple large vacuoles may displace the meiotic spindle from its polar position or disturb the cytoskeleton resulting in fertilization failure. [1 and 2]

Two types of the vacuole in oocytoplasm are seen. Type 1 vacuole is related to apoptosis. The formation of type 1 vacuoles is one of the morphological characteristics of apoptosis. The mechanism responsible for type 2 vacuoles is unknown. Type 1 vacuole can be seen very clearly and they look like lunar craters. Type 2 vacuoles are not obvious as type 1 vacuoles and are flat and more like a bulge than a crater. Type 2 vacuoles are common in MII oocytes. [1] 

References:

  1. https://www.rbmojournal.com/article/S1472-6483(11)00349-X/fulltext
  2. https://www.researchgate.net/publication/229326639_The_oocyte?_sg=hXmowSf9g-nhMoxNcXfHz3khl6F7c6fBTyrlIkTAeAcVyFJR1kzxL4RsmxYM_31frJPpJ8sq8w

Refractile bodies role in oocyte

Refractile bodies are cytoplasmic inclusions that can be dark incorporations, fragments, spots, dense granules, lipid droplets, and lipofuscin. TEM studies and Schmorl staining have shown the refractile bodies >5 µM in diameter showed the conventional morphology of lipofuscin inclusions that consisted of a mixture of lipids and dense materials. Lipofuscin bodies in human oocytes can be detected throughout meiotic maturation (GV, MI, and MII). Accumulation of lipofuscin occurs during the growth phase of the oocyte when dominant follicles are being recruited into the preovulatory pathway. The occurrence of large lipofuscin bodies in normal aging may also be related to conditions of the developing ovarian follicles, such as perifollicular blood circulation and follicular fluid composition. [1]

The average diameter of a recognizable refractile body under bright-field microscopy is approximately 10 µM. According to studies lipofuscin inclusions are associated with reduced fertilization and unfavorable blastocyst development only when their diameter is >5 µM. [1]

References:

  1. https://books.google.co.in/books?id=Kp5_AwAAQBAJ&pg=PA83&lpg=PA83&dq=refractile+bodies+in+oocyte&source=bl&ots=VCxnK7vkwu&sig=Akh6mi0lSgdMs36GtIulV5Zrgfo&hl=en&sa=X&ved=0ahUKEwi5mrDgspvcAhXIT30KHZkqAtI4ChDoAQhMMAc#v=onepage&q=refractile%20bodies%20in%20oocyte&f=false

ZP role in oocyte

The zona pellucid (ZP) is the specialized ECM layer that directly surrounds the oocyte. The ZP is an extracellular translucent matrix composed of long, cross-linked filaments, which first appears during oocyte growth and increases in thickness as oocytes increase in diameter. ZP represents the interface between the oocyte and its enclosing cumulus cells. ZP morphological abnormalities reported were centered in shape or thickness variety. ZP plays a critical role in fertilization by acting as a “docking site” for binding of spermatozoa followed by induction of the acrosome reaction in the zona bound sperm and an adequate block to polyspermy. Any disturbance in ZP morphology or texture may lead to abnormal fertilization result. Narrow PVS and heterogeneous ZP were always concurrences with the abnormal oocytes in many studies reported. [1] The ZP, acting as a protective and selective barrier, actually mediates the metabolic exchanges between the oocyte/embryo and the surrounding microenvironment [2]

A large number of ZP variants (appearance, thickness, irregularities, composition, and organization) have been described with the advent of ICSI. Thicker ZPs are associated with decreased fertilization rates, implantation and pregnancy rates. The ZP also plays a pivotal role in pre-implantation embryos; for instance, abnormalities in oocyte (and thus ZP) shape are associated with irregular cleavage patterns, compromised cell-cell contacts, and subsequent difficulties in the developmental progression. The importance of the ZP continues until the blastocyst stage, a time when the embryo needs to hatch out of the zona prior to implanting into the uterine epithelium. [2]

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3947078/
  2. https://books.google.co.in/books?id=zlB4T2ER4msC&pg=PA197&lpg=PA197&dq=PVS+in+oocyte&source=bl&ots=fw0PfSP80u&sig=e9QGojBuh79bRbFDr2fdrpBxCFI&hl=en&sa=X&ved=2ahUKEwjU9fyN7qzcAhXTXisKHaW1DHoQ6AEwCHoECAkQAQ#v=onepage&q=PVS%20in%20oocyte&f=false

PVS role in oocyte

The Perivitelline space (PVS) represents the acellular compartment in between the plasma membrane of the oocyte and its ZP. [2] The PVS of mammalian oocytes is made up of hyaluronan-rich extracellular matrix prior to fertilization. [1] It becomes clearly visible in a mature oocyte with the extruded polar body located in its most prominent portion. An indistinguishable PVS typically corresponds to immature oocytes while a distinct space to mature oocytes.

It has been proved that large PVS may result in disrupted or compromised communication between the cumulus cells and the oocyte, particularly via gap junctions and transzonal projections. Presence of large PVS will be seen due to over-mature eggs, where such eggs have shrunk in relation with ZP presenting a large gap between the oocyte and surrounding zona. [3] Large PVS is seen when the large portion of the cytoplasm is extruded together with the haploid chromosomal set during PB I formation. [2]   Oocytes with large PVS during ART treatment were usually reported with lower fertilization rate. [1] Granularity in the PVS has been associated with over-maturity of oocytes. Coarse granulation in the PVS is a morphological abnormality occasionally seen after stripping of the oocyte in preparation for ICSI and the presence of coarse granules in PVS is associated with lower pregnancy and implantation rates. [4 and 5]

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3947078/
  2. https://books.google.co.in/books?id=zlB4T2ER4msC&pg=PA197&lpg=PA197&dq=PVS+in+oocyte&source=bl&ots=fw0PfSP80u&sig=e9QGojBuh79bRbFDr2fdrpBxCFI&hl=en&sa=X&ved=2ahUKEwjU9fyN7qzcAhXTXisKHaW1DHoQ6AEwCHoECAkQAQ#v=onepage&q=PVS%20in%20oocyte&f=false
  3. https://www.researchgate.net/publication/229326639_The_oocyte?_sg=hXmowSf9g-nhMoxNcXfHz3khl6F7c6fBTyrlIkTAeAcVyFJR1kzxL4RsmxYM_31frJPpJ8sq8w
  4. https://link.springer.com/article/10.1023/A:1021243530358
  5. https://www.slideshare.net/Yasminmagdi/oocyte-morphology-assessment

Polar body role in oocyte

A polar body is a small haploid cell that is formed concomitantly as an egg cell during oogenesis, which generally does not have the ability to be fertilized. When certain diploid cells in animals undergo cytokinesis after meiosis to produce egg cells, they sometimes divide unevenly. Most of the cytoplasm is segregated into one daughter cell, which becomes the egg or ovum, while the smaller polar bodies only get a small amount of cytoplasm. [1]

Polar bodies eliminate one half of the diploid chromosome set produced by meiotic division in the egg, leaving behind a haploid cell. To produce the polar bodies, the cell divides asymmetrically, which later leads to furrowing (formation of a trench) near a point on the cell membrane. The presence of chromosomes induces the formation of an actomyosin cortical cap, a myosin II ring structure and a set of spindle fibers, the rotation of which promotes invagination at the edge of the cell membrane and splits the polar body away from the oocyte. [1]

Meiotic errors can lead to aneuploidy in the polar bodies, which, in most the cases, produces an aneuploid zygote. Errors can occur during either of the two meiotic divisions that produce each polar body but are more pronounced if they occur during the formation of the first polar body because the formation of the first polar body influences the chromosomal makeup of the second. For example, during the pre-division (the separation of chromatids before anaphase) in the first polar body can induce the formation of an aneuploid polar body. Therefore, the formation of the first polar body is an especially important factor in forming a healthy zygote. [1]

Oocytes showing an intact PB I give rise to higher rates of implantation and pregnancy, probably due to an increase in blastocyst formation. Recent research has shown that some polar body abnormalities may be an artifact of oocyte handling or aging. Abnormal morphology of PB1 in MII oocytes attributes to chromosomal aneuploidy of the oocyte. As PB 1 extrusion is directly related to spindle formation and sister chromatid exchange, it could be the most likely point of non-disjunction or aneuploidy formation. Fragmentation rates of the PB1 depend on the time elapsing between retrieval, denudation and ICSI performance. [2]

References:

  1. https://en.wikipedia.org/wiki/Polar_body
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663962/

Oocyte Granularity 

Granularity in ooplasm of the oocyte refers to the presence of “heterogeneous area”. Granularity is correlated with localization of mitochondria within the cytoplasm of the cell.

It also represents a domain of high ATP request which is very much necessary for normal development of embryos. A healthy MII oocyte should contain a clear and moderately granular cytoplasm. Top quality oocytes have the granularity homogeneously distributed at the sides of the oocyte cytoplasm and not at the center.

Oocyte with centrally located granular cytoplasm (CLGC) is considered as a dysmorphic oocyte. These kinds of oocyte show high chromosomal abnormalities like aneuploidy (presence of an abnormal number of chromosomes).

Also, the oocytes which lack granularity are considered as a bad oocyte. The severity of granulation is based on the diameter of the granular area, depth of lesion and crater-like appearance. [1,2 and 3]

References:

  1. https://www.researchgate.net/publication/229326639_The_oocyte?_sg=hXmowSf9g-nhMoxNcXfHz3khl6F7c6fBTyrlIkTAeAcVyFJR1kzxL4RsmxYM_31frJPpJ8sq8w
  2. http://atlas.eshre.eu/es/14611418225805670
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3455008/

 

RoboICSI is recognised at the Medicall Innovation awards 2021

Medicall is India’s largest hospital equipment expo.

Each year, Medicall recognises promising Made in India, made for the world intentions every year through the Medicall Innovation Awards.

SpOvum’s RoboICSI was recognised at the Medicall 2021 Innovation awards in the Medical Equipment category.

This was an opportunity to present our innovation to a panel of experienced Jury and diverse audience at the Medicall 2021, helping get valuable inputs, apart from improving our outreach.

SpOvum’s Smart Double Witness featured in the news

SpOvum’s Smart Double Witness (SDW) helps clinic prevent accidental mix up of gametes across different couples.

This first-of-its-kind system made in India, is being adopted at the Meva Chaudhary Dhiraj IVF Clinic at Jhansi.

This has been covered by the local news.

https://m.facebook.com/story.php?story_fbid=962778377642587&id=100756932263075

Retweet: Another data-backed tweet supporting declining population and and fertility rates

What are the most common causes of infertility?

Infertility is the inability to conceive after a year of trying or the inability to carry a pregnancy to term. There are several causes of infertility, and the specific cause can vary from one couple to another. Some of the most common causes of infertility include:

  1. Ovulation disorders: Ovulation disorders, such as polycystic ovary syndrome (PCOS) and irregular menstrual cycles, can affect fertility by preventing the release of eggs or making it difficult for eggs to be fertilized.
  2. Fallopian tube problems: Damage or blockage of the fallopian tubes can prevent the sperm from reaching the egg, or prevent the fertilized egg from reaching the uterus.
  3. Uterine or cervical problems: Abnormalities of the uterus or cervix, such as scarring or inflammation, can affect fertility.
  4. Male infertility: Male infertility can be caused by low sperm count, abnormal sperm shape or motility, or other issues with the production of sperm.
  5. Unexplained infertility: In some cases, the cause of infertility is not clear, even after testing.

It is important for couples experiencing infertility to discuss their concerns with a healthcare provider and undergo testing to determine the cause of the fertility issue. This can help inform the appropriate treatment plan.

DISCLAIMER: The information provided in here is for general educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for any questions you may have regarding a medical condition. Do not rely on the information provided here for decision-making or self-treatment. If you are experiencing a medical emergency, seek immediate medical attention.

What are some risk factors associated with infertility

Infertility is the inability to conceive after a year of trying or the inability to carry a pregnancy to term. There are several risk factors that can increase a couple’s likelihood of experiencing infertility. These risk factors include:

  1. Age: As a woman gets older, her fertility naturally declines. This is due to a decrease in the number and quality of eggs that are available for fertilization. The same is true for men, although to a lesser extent.
  2. Lifestyle factors: Certain lifestyle factors, such as smoking, excessive alcohol consumption, drug use, and being overweight or underweight, can increase the risk of infertility.
  3. Health conditions: Certain health conditions, such as polycystic ovary syndrome (PCOS), endometriosis, and sexually transmitted infections (STIs), can affect fertility.
  4. Environmental factors: Exposure to certain environmental toxins, such as pesticides and heavy metals, can increase the risk of infertility.
  5. Family history: A family history of infertility can increase the risk of fertility problems in both men and women.
  6. Medical treatments: Some medical treatments, such as chemotherapy and radiation therapy, can affect fertility.

It is important for couples to be aware of these risk factors and to discuss any concerns with a healthcare provider.

DISCLAIMER: The information provided in here is for general educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for any questions you may have regarding a medical condition. Do not rely on the information provided here for decision-making or self-treatment. If you are experiencing a medical emergency, seek immediate medical attention.

What are some of the common infertility treatments?

Infertility is the inability to conceive after a year of trying or the inability to carry a pregnancy to term. There are several treatments available to help couples overcome infertility and have a successful pregnancy. Here are some common infertility treatments:

  1. Fertility medications: These medications can help regulate a woman’s menstrual cycle and stimulate the production of eggs. Examples include clomiphene citrate (Clomid), letrozole, and gonadotropins.
  2. Intrauterine insemination (IUI): IUI involves placing sperm inside a woman’s uterus to facilitate fertilization. It is often used in cases of mild male factor infertility or when the woman is using donor sperm.
  3. In vitro fertilization (IVF): IVF involves fertilizing an egg with sperm in a laboratory dish, and then transferring the resulting embryo into the woman’s uterus. It is often used in cases of infertility that cannot be treated with other methods, such as when the woman has blocked or damaged fallopian tubes or the man has a low sperm count.
  4. Intracytoplasmic sperm injection (ICSI): ICSI involves injecting a single sperm directly into an egg to facilitate fertilization. It is often used in cases of male factor infertility or when the couple is using donor sperm.
  5. Assisted reproductive technologies (ARTs): ARTs are a group of fertility treatments that involve the handling of eggs and sperm in the laboratory. Examples include gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT).
  6. Surgeries: Certain infertility issues, such as blocked fallopian tubes or uterine abnormalities, may be treated with surgery.
  7. Donor eggs or sperm: In some cases, couples may choose to use donor eggs or sperm to achieve pregnancy.

It is important for couples experiencing infertility to discuss their treatment options with a fertility specialist and to consider the potential risks and benefits of each option.

DISCLAIMER: The information provided in here is for general educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for any questions you may have regarding a medical condition. Do not rely on the information provided here for decision-making or self-treatment. If you are experiencing a medical emergency, seek immediate medical attention.

Major Takeaways from National Neonatology Forum’s (NNF) Karnataka State Chapter, July 2020

Guidelines for Antenatal, Intranatal and Postnatal and New-born Management of COVID-19

The unprecedented scale of coronavirus infections or COVID-19 pandemic has affected the lives of millions of people across the globe. This has put tremendous strain on the health-care facilities and doctors, who are facing the direct brunt of this crisis and face numerous challenges in diagnosing and treating the affected people.

The central and state governments have been actively working with medical bodies such as ICMR and health-care facilities to formulate management guidelines for effectively tackling the growing number of COVID-19 infections.

Some of the most vulnerable population groups in this COVID-19 pandemic are pregnant mothers, mothers who have recently delivered a child and new-born babies. The National Neonatology Forum’s (NNF) Karnataka State Chapter has taken the initiative to draft and issue the “Guidelines for Antenatal, Intranatal and Postnatal and New-born Management of COVID-19”.

The NNF Karnataka State Chapter has prepared a comprehensive and evidence-based set of guidelines for the diagnosis and management of COVID-19 during pregnancy and delivery. It has been prepared by leading and eminent Neonatologists, Gynaecologists and Obstetricians from Karnataka.

This guideline prescribing standard operating procedures (SOPs) for the management of pregnant mothers and new-borns was released on 24th July 2020. The guideline has been duly endorsed by the Honourable Chief Minister of Karnataka, Shri BS Yediyurappa, Deputy Chief Minister, Dr. Ashwath Narayan CN, Honourable Health Minister of Karnataka, Shri B. Sreeramulu and Honourable Medical Education Minister, Dr. K. Sudhakar.

Brief Background of COVID-19

Towards the end of 2019, a coronavirus was identified to be the cause of a cluster of pneumonia cases in the city of Wuhan in China. The virus rapidly reached an epidemic scale across China and subsequently throughout the world. In February 2020, the World Health Organization (WHO) designated the disease caused by the coronavirus as COVID-19.

Recent studies have reported a variation in the viral genome of the coronavirus which has improved its ability to infect human cells. It has now become the dominant strain responsible for most COVID-19 cases. Common symptoms include fever, cough, sore throat, breathing issues, headache, and abdominal pain.

The coronavirus is primarily transmitted through close-range person-to-person contact mainly via respiratory droplets from an infected individual. Other modes of transmission are airborne, fomite, faecal-oral, blood born, and mother to child. Globally there are now close to 24 million confirmed COVID-19 cases and 3.2 million cases in India alone as of August 2020.

Management of COVID-19 and Pregnancy

Pregnant women undergo physiological and immunological changes. In the case of COVID-19 infection, most pregnant women experience mild or moderate symptoms. With the existing data, there is no evidence of an increased risk of miscarriage in COVID-19 positive mothers. The risk of vertical transmission or transmission from mother to foetus is also very low. Transmission of COVID-19 from breast milk to baby is extremely rare.

Source: NNF Karnataka State Chapter: Guidelines for Antenatal, Intranatal and Postnatal and New-born Management of COVID-19, July 2020

Highlights of Guidelines for Obstetric Health Care

  • All pregnant women will be treated as COVID-19 suspects and all precautionary measures will be followed.
  • The pregnant patient will be placed in a separate ward, negative pressure will be maintained in the Operation theatres (OT), the patients will wear a triple-layer mask.
  • All healthcare professionals must wear Personal Protection Equipment (PPE).
  • The Department of health and family welfare should be immediately notified for suspected COVID-19 cases and testing should be done at Government accredited labs.
  • The healthcare centres must maintain a registry of confirmed COVID-19 cases.
  • Healthcare centres will follow universal mask policy i.e. all visitors, patients, doctors, medical and non-medical staff will wear masks.
  • Sanitization of diagnostic equipment such as ultrasound machines will be done after each use.

Criteria for testing for COVID-19

Under certain circumstances, the pregnant patient will be needed to undergo testing for COVID-19. The following criteria will be used to prescribe the COVID-19 test:

  • Symptomatic persons will travel history in the past 14 days.
  • Patients with severe respiratory illness.
  • An asymptomatic person who has had direct contact with confirmed COVID-19 case.
  • In addition, ICMR has announced mandatory testing of patients living in COVID-19 hotspots or containment zones even if they are asymptomatic.

Management of pregnant patients with COVID 19

Most COVID-19 positive pregnant patients exhibit only mild symptoms. Severe symptoms are observed among immunosuppressed patients and patients with chronic conditions such as diabetes, lung disease, etc. Nevertheless, apart from the general precautions, particular considerations will be given to pregnant patients with COVID-19. Some of these include:

  • Maintaining high oxygen levels and keep saturations > 94%.
  • Conduct radiographic investigations such as chest X-ray using abdominal shielding.
  • Periodic blood analysis to monitor white blood cell count and prescribe antibiotics when necessary.
  • Current guidelines however do not recommend the use of Hydroxychloroquine or antiviral drugs in pregnant women.

Postnatal care for mothers with COVID-19

Limited information is available on the severity of COVID-19 symptoms exhibited in new-born babies born to mothers with COVID-19. However, the risk of transmission from mother to child after birth exists. Individualized care is recommended on a case-to-case basis after a thorough risk and benefit analysis with neonatologists and the concerned families.

Breastfeeding guidelines for mothers with COVID-19

It is extremely rare for transmission of COVID-19 from mother to baby through breast milk. It is strongly recommended to initiate breastfeeding within 1 hour of birth and that the baby is exclusively breastfed for the first 6 months.

Source: NNF Karnataka State Chapter: Guidelines for Antenatal, Intranatal and Postnatal and New-born Management of COVID-19, July 2020
  • Mothers confirmed with COVID-19 should breastfeed the baby with facemask and practice hand hygiene.
  • Face-mask should be worn during all events of contact with new-born.
  • If the baby and mother are required to be separated temporarily, expressed breast milk is strongly recommended to be given to the new-born by a healthy caregiver.
  • Gloves must be worn by the caregiver when receiving bottles of expressed breast milk. After securing the cap, the bottles should be wiped with viricidal wipes and air-dried on a clean surface.

In addition, the NNF Karnataka State Chapter also provides general guidelines for Basic Hospital Management, Visitor Policy, Managing Biomedical Waste, Mental Health and Wellness support for Patients and Healthcare Professionals and District Wise Government Helpline numbers in Karnataka.

Acknowledgements: We would like to acknowledge the Dr. Prashnath and Dr. Jyothi Bandi from LittleBaby Clinic for kindly permitting us to disseminate this information for the benefit of all.