A lot of people have been asking whether it is the right time to try to get pregnant or start fertility treatments now that things seem to be headed in that direction. At Hoag Hospital, they are starting elective cases starting May 1 with pre-op testing for COVID-19.
My opinion is that we are probably going to be dealing with this virus for a while and I would hate for people to delay starting a family for such an unknown situation. Especially since we know that there is decreasing fertility as women get older and many women have already delayed child-bearing as they pursued schooling and careers. Orange County has been doing well and I think now medical facilities are well prepared and adequately equipped.
For now, we don't have any information that indicates pregnant women are at higher risk for complications than the general population and we have no data indicating higher risk of birth defects. There are some theories that this particular disease increases the risk of blood clotting, hence a potential increase in strokes and heart attacks. Since pregnant women are at higher risk of blood clotting in general, we are concerned about complications from this which can also be serious effects on the fetus including miscarriage and stillbirth. Data is still being collected to see if there really is an effect of the virus on these terrible outcomes. There are many people doing research on whether using aspirin or other blood thinners can prevent these outcomes. Stay tuned... If you are thinking about getting pregnant just know that we would recommend you be extra cautious and continue social distancing even when other people may start to get back to more normal behavior.
As time goes on, we are seeing more and more options for testing as well which can help us better manage and counsel patients. Currently, the hospital has a rapid PCR test available, but only patients who are symptomatic are getting the test. Hoag urgent care also has testing available with 1-3 day turn around. I think we are moving towards a strategy of testing more patients to see if they have a current infection or if they had it in the past like we do for many other viruses (such as herpes, chicken px, rubella, parvovirus, etc.) We just need more data on how good these tests actually are (statistically we call it sensitivity and specificity of the test). I think we are working on implementing a strategy for all inductions and Cesareans to be tested prior to admission as well to keep the hospital as safe as possible and I think the precautions will continue for now!
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