COVID-19 infections & pregnancy

This book entitled ‘COVID-19 Infection and Pregnancy’ by Professor Ahmed M. Maged El-Goly from Kasr Alainy Medical School, Cairo University, is very concise, complete and informative. It essentially covers all aspects for obstetricians and will be welcomed by both medical students and practitioners. In general, the content is up to date, compiled carefully taking into all aspects and sufficiently elaborate for students and convenient for reference.

The authors have been successful in their effort to provide evidence to correlate all aspects of epidemiology, clinical feature during pregnancy, immunological response as well as immunological changes in pregnancy. A specific in-depth coverage of COVID-19 behaviour during pregnancy and diagnosis of COVID-19 infection in pregnancy is very impressive for clinicians. In particular, updated topics on various laboratory investigations and biomarkers, imaging techniques: radiological, ultrasonography and CT scan, add value to the book. Intermix of tables, pictures, recommendations and guidelines maintains the interest of the readers. I liked chapters detailing with follow up, evaluation for peripheral vascular thrombosis and foetal assessment and management.

The book starts with the highlight of COVID-19 pandemic and traces the pathogenesis and viral life cycle with colourful simple diagrams in Chapter 1 on epidemiology, virology and the history of infection.

Chapter 2 on immunological changes in pregnancy and its relation to COVID-19 infection discusses the immune system and respiratory adaptation to pregnancy. It states that population of different ethnicities seem to respond differently to gestation. In addition, pulmonary adaptation may increase susceptibilities and favour a severe course in viral respiratory infections. Data of various infections and its clinical course were compared in pregnant and non-pregnant women. A separate subsection deals with COVID-19 and pregnancy issues.

Chapter 3 on the diagnosis of COVID-19 infection in pregnancy initially provides information about physiological changes (immunological, respiratory, coagulation and endothelial cell responses) with pregnancy and then covers the role of all modalities of investigations. It is good to learn about their relevance and importance for foetal monitoring and well-being.

The chapter on management during pregnancy, labour and puerperium (Chapter 4) highlights the challenges during pregnancy. A great emphasis is given on the prevention of infection as there is no definitive treatment of COVID-19 infection and pregnant women are more vulnerable to viral infections. It also summarizes guidelines by various professional bodies and international societies and organizations for intrapartum care of pregnant patients during the COVID pandemic.

Chapter 5 discusses various lines of treatment of COVID-19 infection. Various drugs under subheadings of antivirals, antibacterials, antimalarials, antiparasitics, anticoagulants and others, including oxygen therapy with special considerations in pregnancy and lactation, have been elaborated in detail.

Chapter 6 entitled ‘Prognosis and outcomes of COVID-19 infection during pregnancy’ introduces severe disease and intensive care unit admission. It covers obstetric outcomes and maternal, foetal and neonatal prognosis.

More and more evidence and experiences are coming, which might change the practice and recommendation in the near future. However, this book is a good resource for all specialties dealing with COVID-19 infection at present.

I congratulate the editor and all authors for successfully compilation of evidence materials of this challenge during pregnancy.