Call for pregnant women to be moved up vaccine list amid new Covid-19 concerns

Call for pregnant women to be moved up vaccine list amid new Covid-19 concerns

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Pregnant women should be moved up the priority list for vaccinations, a Cork obstetrician and professor has said.

Her comments come after four women in Ireland with Covid-19 had stillbirths, potentially linked to a rare inflammation called Covid Placentitis.

Professor Keelin O’Donoghue, head of the Pregnancy Loss Research Group at Cork University Maternity Hospital, is one of the few obstetricians who has successfully treated a pregnant woman with this little-studied condition.

She said: “There is an argument for moving pregnant women up the priority list for vaccination. For those who are currently in the priority groups, we would be happy to encourage vaccination. 

The safety data on vaccination in pregnancy is increasing all the time; from the countries who have vaccinated more than us, particularly the US and the UK.” 

Improving community vaccination rates will also help pregnant women to avoid Covid-19, she said.

Professor Keelin O’Donoghue consultant obstetrician and gynaecologist at CUMH.
Professor Keelin O’Donoghue consultant obstetrician and gynaecologist at CUMH.

Prof O’Donoghue, who is also a Fellow of the Royal College of Obstetrics and Gynaecologists, said it is important to state that this condition is extremely rare — but she also voiced caution.

"Are we just seeing these four cases as a random cluster, and are we seeing these cases by chance?” she said.

She reassured women that concerns expressed last year about rising stillbirth rates have not been borne out in any country.

“There is, as yet, no evidence from international literature ... reporting large numbers of Covid pregnancies that there is any increase overall in stillbirth rates,” she said. 

"We are just not seeing that in the literature, which is reassuring.

This condition, an inflammation of the placenta, came to attention in Ireland on Thursday. The National Public Health Emergency Team said four cases are under investigation, with hospitals and GPs alerted to the cases.

Prof O’Donoghue said: “In stillbirth, we are talking about something that is a really tragic outcome of pregnancy — it is nearly always unexpected. There are four bereaved families at the heart of this.” 

In her role as an obstetrician at Cork University Maternity Hospital, she treated a woman last year with Covid-19. Due to concerns about reduced foetal movement in the latter stages of her pregnancy, the woman was given a C-section.

Both mother and baby girl did well, leaving the hospital eight days later, but tests on the placenta and a review of global studies found similarities between her situation and a tiny number of other pregnant women.

Prof O’Donoghue said: “When we did our review, Brendan Fitzgerald, the lead pathologist, found 11 other cases that were quite similar to our reported case. 

"In our case, it’s important to say, there was a good outcome for mother and baby, even in the presence of this abnormal placenta.” 

Dr Fitzgerald, a histopathologist at Cork University Hospital said the placenta and cord are “a baby’s lifeline to its mother".

“From studying placentas in cases of maternal Covid-19, we now recognise that SARS-CoV-2 — the virus that causes Covid-19 — can uncommonly directly infect the placental tissue and cause placental injury,” he said, but also stressed how rare the condition is.

Women affected by stillbirth can get support here.

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