Increased meconium, stillbirths related to Covid-19?

Doctors in hospitals across the Bengaluru city who are handling deliveries of Covid-19 positive mothers are seeing babies passing meconium (newborn's first poop) while still in the womb, and intrauterine fetal deaths (stillbirths) ever since the pandemic started. Babies typically pass meconium in the first few hours and days after birth. This may be a result of Covid-19, they say. These observations come when research shows vertical transmission is not happening in most of the cases.

This is observed in either Covid-19 positive labouring moms or novel coronavirus suspects.

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Vani Vilas Hospital obstetricians have delivered 148 babies of Covid-19 positive mothers. Dr Anitha GS, Assistant Professor, Bangalore Medical College and Research Institute (BMCRI), said, "We have noticed a lot of meconium being passed in-utero which is a sign of fetal distress due to coronavirus. When the mother has fever, the baby's temperature also goes up. In that distress, the baby may pass faeces and swallow it. Sometimes it goes to the lungs and causes pneumonitis. As far as intrauterine deaths are concerned, we have seen two so far. More research is required through more studies since it is a relatively new disease."

The doctor went on to cite an example of a 35-year-old Covid-19 positive woman who had her first baby via a C-section. This is the 97th baby of Covid-19 positive mothers delivered by Vani Vilas hospital obstetricians. "She had come with severe BP and diabetes. The baby had thick meconium," she said.

There are 12 obstetricians at M S Ramaiah Hospital that houses 210 Covid-19 patients. The hospital has so far delivered babies of only asymptomatic Covid-19 mothers, around 16 of them, and the hospital has set a protocol to deliver them via C-section at 39 weeks. The hospital puts its labouring mothers on prophylaxis Heparin. "This reduces the chances of meconium or intrauterine death," says Dr Sujani BK, head of the Department of Obstetrics and Gynaecology, M S Ramaiah Hospital.

"For a non-Covid-19 mother, a baby coming out of the vaginal route is beneficial as it compresses the chest and the baby aspirating it is less common. By bringing the baby out by a C-section, the baby may take a breath and aspirate the meconium. It could be because of Covid-19 because the blood circulation may be hampered to a certain extent. Only two mothers had babies who passed meconium in their wombs at our hospital and both babies turned out fine," she said.

Dr Vijayalakshmi V, Gynaecologist and Obstetrician, KC General Hospital, said the hospital has seen two intrauterine fetal deaths this month alone. The hospital has done five C-sections and six normal deliveries. "The first case of intrauterine death was because of the separation of the placenta in the womb itself that might be because of Covid-19. The second stillbirth's cause is still not known."