Rui-Hong Xue

and 1 more

Sir, We read with interests the article by Lorraine S Kasaven and collegues, entitled “Implications for the future of Obstetrics and Gynaecology following the COVID‐19 pandemic: A commentary”. They discussed the impact of COVID-19 on practice of Obstetrics and Gynaecology, and summarized detailed suggestions. We would like to emphasize the importance of prevention in pregnancy.Though the management guidelines during pregnancy are evolving continuously, pregnant women suffered with COVID-19 mean worse pregnancy outcomes, both physically and mentally, especially during the first or second trimester, both the patient and doctor may stuck in the middle. What is worse, no drug or vaccine has been proved to be effective and safe enough to prevent COVID-19 until now.Physical distancing, face masks, and eye protection have been proved to be effective in preventing person-to-person transmission of SARS-CoV-2 and COVID-19. As confirmed that public health interventions could temporally improve control of the COVID-19 outbreak.“Don’t wait to lose to know how to cherish”, so as to health. After all, it could not be regarded as common flu, COVID-19 has a strong contagion effect and could cause significant morbidity and mortality. In the 1902 paper, Ballantyne said, “as with the premature, the ideal plan of procedure is prevention”, so with the COVID-19. With strong awareness of prevention and effective measures to be taken among the non-infected population, the current situation will gradually get better, and people will definitely defeat the epidemic at the end.Rui-hong Xue,1 He-feng Huang11International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Sir, We read with interests the article by Kate F Walker and colleagues, entitled ”Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: A systematic review and critical analysis”. We would like to discuss some points that merit further.In the article, the authors systematically analyzed the mode of delivery on the infection rates of COVID-19 of newborn, they found that the infection rate is no greater when the baby is born vaginally, breastfed or allowed contact with the mother, compared with those performed with Caesarean sections.Despite the limitations, especially the retrospective feature, this study provided important information for the selection of mode of delivery with COVID-19, that Caesarean birth was not better than virginal delivery on neonatal infection outcomes.However, the main defect was the lacking severity evaluation of COVID-19 of the mothers, which may result in selective bias, or even alter the conclusion. Clinically, pregnant women combined with more severe degrees of COVID-19 always prefer Caesarean delivery than virginal delivery. Possibility was that the protective effects of Cesarean birth might have been neutralized by the severity of COVID-19.COVID-19 is a kind of highly contagious respiratory virus, Both the patients and doctors feel anxious about the possible increased infection risk during the second stage of the labor, for the virginal labor usually takes longer than Caesarean.Considering the above, prospective evaluation the safety of mode of delivery with COVID-19 would have important significance for clinical practice.Rui-hong Xue11Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China