IASbhai Daily Editorial Hunt | 14th Sep 2020
Remember, today is the tomorrow you worried about yesterday.– Dale Carnegie
EDITORIAL HUNT #135 :“Neonatal Care and the Pandemic | UPSC“
M.S. Seshadri | T. Jacob John
Neonatal Care and the Pandemic | UPSC
M.S. Seshadri is former Professor and HOD Thirumalai Mission Hospital, Ranipet, Tamil Nadu.
T. Jacob John is former Professor and HOD ,Indian Academy of Pediatrics
Coronavirus fears and preconception advice
With widespread community transmission, women in particular face a risk; a health advisory is essential
SYLLABUS COVERED: GS 1 : 3 : Issues related to Women : Malnutrition
Neonatal Care and Mother’s wellbeing needs policy driven attention during pandemic. Device a global as well as national policy for the same . -(GS 1)
- Virus and the risks
- Infection and threats
- Mother’s Health
- LOST SIGHT : In our preoccupation with managing the COVID-19 pandemic, we should not lose sight of special issues that may pose problems for women in the reproductive age group.
- GUIDELINES : The World Health Organization (WHO) and the Indian Council of Medical Research (ICMR) have provided guidelines to address this issue.
- All available guidelines are silent on this issue.
NEED FOR PROTOCOLS, FOLLOW-UP
- REPLICATION OF VIRUS : The SARS-CoV-2 virus that causes COVID-19 has a special predilection for the cells that form the inner lining of blood vessels.
- RISK : Therefore, organs that have a large number of blood vessels are particularly at risk.
- LIFELINE : The placenta, a unique organ in pregnancy — the source of nourishment for the growing foetus — is highly vascular.
- TRANSFUSION : It has been clearly demonstrated that in mothers infected close to the time of delivery, the virus can infect the placenta.
- LIKELIHOOD : While most newborn babies do not develop clinical disease, rare neurologic problems have been described in them.
- SPREAD : RT-PCR testing of pregnant mothers admitted for delivery reveal that about 8-10 % of mothers are indeed infected by SARS CoV-2.
- CONCERN : The ICMR along with the professional bodies concerned should ensure that the treating teams are aware of the potential for trans-placental transmission of the virus.
- FOLLOW UP : Establish protocols for careful periodic follow-up of the new-born of infected mothers.
- LIFE THREATENING : In the first trimester of pregnancy, many infections such as those caused by rubella and zika virus cause severe congenital abnormalities in the foetus.
ISSUE OF CONTRACEPTION
- AWARENESS IS THE KEY : If it is a florid abnormality it would be known by now, but if subtle, by the time the effects on the foetus are recognised, it may be too late.
- ANTICIPATION AND CARE : It is wiser to be cautious and advise effective contraception to postpone pregnancies till the probability of maternal viral infection is minimal.
CUTTING INFECTION THREAT
- CONTRACEPTION : If women adopt contraception, they will not need antenatal clinic visits during epidemic times.
- HOSPITAL VISITS : Antenatal women constitute a large proportion of subjects who need to visit hospitals regularly .
- POSSIBLE EXPOSURE : Considerable proportions of health-care workers at the primary and secondary levels are occupied with their care.
- STRESSED HEALTHCARE SYSTEM : There will be less pressure on the health-care system which is already struggling under the burden of this epidemic.
- DISTRESSED FAMILIES : The lower birth rate will ensure fewer children in the post-epidemic phase for economically distressed families to care for .
- NEW PREGNANCIES : Since the outcome is unsuccessful in about half the pregnancies (embryo/foetal loss), the daily new pregnancies in India would be more than 15,00,000.
- MEDICAL ATTENTION : They may not come to medical attention unless a family contact has RT-PCR positive symptomatic disease.
- Infected women should have a more intensive follow-up during their ante-natal period.
- Analysis of these results will be vital to state clearly about any abnormalities .
- It is important, therefore, to advise all women in the reproductive age group to practise effective contraception .
- VIRUS IS HERE TO STAY: It is predicted that this virus will not go away but will stay on as an endemic problem.
- VICE VERSA : While this problem of high birth rate in India and China, it will also be a public health problem in countries with a low birth rate, where states are concerned about ‘population wealth’.
- ASSESSMENT : The ICMR and governments globally would do well to assess the situation, review all available scientific evidence and formulate and circulate an appropriate health advisory.
SOURCES: THE HINDU EDITORIAL HUNT | Neonatal Care and the Pandemic | UPSC