Summary of COVID-19 medicines guidance: Obstetrics and gynaecology

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.

This page has been put together rapidly in relation to the COVID-19 pandemic.

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 Obstericians and Gynaecologists: Coronavirus (COVID-19) infection and pregnancy

Last updated: 13th May

  • Epidural or spinal analgesia is not contraindicated in the presence of coronavirus. Epidural analgesia should therefore be recommended in labour to women with suspected/confirmed COVID-19 to minimise the need for general anaesthesia if urgent delivery is needed.
  • There is no evidence to suggest that steroids for fetal lung maturation, when they would usually be offered, cause any harm in the context of women with confirmed COVID-19. Steroids should therefore be given when indicated.
  • All pregnant women admitted with suspected / confirmed COVID-19 infection should receive prophylactic LMWH, unless birth is expected within 12 hours. Additionally women who develop new symptoms of COVID-19 during admission should be prescribed prophylactic LMWH.
  • Following birth, women with suspected/confirmed COVID-19 should be assessed for VTE risk and administered the first dose of LMWH as soon as possible if there has been no postpartum haemorrhage and regional analgesia used.
  • At the time of discharge from hospital following a period of care for confirmed COVID-19 infection, all women should be prescribed at least 10 days of prophylactic LMWH.

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

Last updated: 3rd June

  • 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.

UNICEF: Infant feeding during the COVID-19 outbreak

Last updated: 14th May

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

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

Last updated: May (v1.2)

  • 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 below, however safety data are lacking for some treatments, and efficacy is yet to be established for all treatments.
  • The following medications are discussed; hydroxychloroquine, azithromycin, tocilizumab, lopinavir/ritonavir, interferon beta-1a, corticosteroids, remedesivir, colchicine, imatinib and baricitinib.