Summary of COVID-19 medicines guidance: Obstetrics and gynaecology

Nancy Kane, Senior Medical Information Scientist, Regional Drug & Therapeutics CentrePublished Last updated See all updates

This page summarises and signposts to medicine related guidance we’re aware of from professional and government bodies relating to coronavirus and obstetrics and gynaecology.

Our advice is constantly reviewed as the pandemic situation evolves.

Whilst we have tried to ensure that the information on this page is complete, please report a concern if you feel anything is omitted or inaccurate.

To see our professional guidance summaries for other clinical areas, click here

Advice in this area includes:

Royal College of Obstetricians and Gynaecologists: Coronavirus (COVID-19) infection and pregnancy

Last updated: 19th February 2021

  • Pregnant women should receive folic acid and vitamin D supplements as per national guidance.
  • All pregnant women should be vaccinated against influenza.
  • Vaccination against COVID-19 should be considered where the risk of infection is high or cannot be avoided, or where the woman has an underlying condition that puts her at very high risk of serious complications of COVID-19.
  • Where normally indicated, thromboprophylaxis should still be offered and administered as prescribed during the COVID-19 pandemic.
  • All pregnant women admitted with suspected or confirmed COVID-19 should be offered prophylactic LMWH, unless birth is expected within 12 hours or there is a significant risk of haemorrhage.
  • All pregnant women who have been hospitalised and have had confirmed COVID-19 should be offered thromboprophylaxis for 10 days following hospital discharge. A longer duration of thromboprophylaxis should be considered for women with persistent morbidity.
  • If women are admitted with confirmed or suspected COVID-19 within 6 weeks postpartum, they should be offered thromboprophylaxis for the duration of their admission and for at least 10 days after discharge. Consideration should be given to extending this until 6 weeks postpartum for women with significant ongoing morbidity.

 

Royal College of Obstetricians and Gynaecologists: Coronavirus (COVID-19) infection and abortion care

Last updated: 31st July 2020

  • The Royal College of Obstetricians & Gynaecologists have released guidance on abortion care during the COVID-19 pandemic.
  • For a home-use treatment package, providers should package the medicines needed (mifepristone, misoprostol, any analgesia or anti-emetic indicated). The treatment package can be sent via the post or if medicines are collected this should be done with minimal contact.
  • Women may find the pain from medical abortion to be particularly distressing. Therefore should offer a stronger analgesic such as codeine in addition to NSAIDs and paracetamol if requested, but in restricted quantities.
  • Contraception options should be discussed and a method of oral contraception be available in the treatment package as access to a LARC method is restricted.

 

Royal College of Obstetricians and Gynaecologists: Coronavirus (COVID-19) vaccination in pregnancy 

Last updated: 30th June 2021

  • Vaccination should be offered to pregnant women at the same time as the rest of the population, based on age and clinical risk
  • Pregnant women should be offered the Pfizer-BioNTech or Moderna vaccines unless they have already had one dose of the Oxford-AstraZeneca vaccine, in which case they should complete the course with Oxford-AstraZeneca
  • In general, there are no known risks from giving inactivated or recombinant vaccines in pregnancy, or while breastfeeding, and there is therefore no reason to suppose that the adverse effects from these COVID-19 vaccines should be different for pregnant women compared to non-pregnant women.
  • COVID-19 vaccines can be given at any time in pregnancy. Breastfeeding women can receive a COVID-19 vaccine; there is no need to stop breastfeeding to have the vaccine.
  • Pregnant women should be supported, if necessary, to come to an informed decision about vaccination. An informed decision-making process should cover the options for timing of vaccination, the benefits and risks of vaccination, and the risks of declining vaccination. The RCOG Information sheet and decision aid can be used to aid counselling
  • Q&As are also available on COVID-19 vaccines, pregnancy and breastfeeding.

For further information on COVID vaccines see Using COVID-19 vaccines in women of child bearing potential.

 

UK Teratology Information Service: Medications used to treat COVID-19 in pregnancy

Last updated: December 2020

  • UKTIS have produced summary information on the available evidence regarding the fetal risk associated with medications that are being used in treatment of patients with COVID-19.
  • Owing to the potential for COVID-19 to cause significant disease and mortality in pregnant women, the benefits of maternal treatment should be carefully considered against the fetal/neonatal risks.
  • In the context of COVID-19, pregnancy, in itself, is therefore not a contraindication to any of the treatment options discussed, however safety data are lacking for some treatments, and efficacy is yet to be established for all treatments.
  • The following medications are discussed; aspirin, REGN-COV2, anakinra, bamlanivimab, tocilizumab, hydroxychloroquine, azithromycin, lopinavir/ritonavir, interferon beta-1a, corticosteroids, remedesivir, colchicine, imatinib, baricitinib and Interferon beta-1a.

 

UNICEF: Statement on infant feeding during the coronavirus (COVID-19) outbreak

Last updated: 20th April 2021

Unicef has released general guidance around infant feeding during the COVID-19 pandemic. This includes information on use of and access to infant formula.

 

Change history

  1. Resources checked and information remains correct
  1. Updated to reflect most recent RCOG guidance on COVID-19 vaccination in pregnancy
  1. RCOG guidance on vaccines in pregnancy and breastfeeding added.
  1. Resources checked and information remains correct
  1. Published