Table 1.

Guidelines provided by few representative organizations for the pregnant women during COVID-19 pandemic.

Name of the organization	Guidelines for the pregnant women	References
World Health Organization (WHO)	• Regular checkup and monitoring • Isolation of affected women • Provision of skilled medical staff with all associated remedial provisions • Counselling to deal with the physiological and mental stress during pregnancy • Thorough counseling of pregnant women related to the breast feeding and isolation of the fetus after birth • Expert decision for the vaginal or cesarean delivery • Use of minimum essential protective gears and maintenance of proper hygiene to prevent the transmission of infection • Routine ante-natal or post-partum care of fetus and mother	[127]
Centers for Disease Control and Prevention (CDC)	• Confirmed/suspected COVID-19 pregnant women should be isolated immediately and notified to obstetric unit • Immediate emergency care should be provided to the pregnant women with COVID-19 • Regular provision of counselling related to the prenatal or postpartum care • Maintenance of proper hygiene including washing of hands with soap or sanitize with 60% alcohol, using mask etc. before breast feeding the newborn baby • The women suspicious or infected with SARS-CoV-2 virus infection must be isolated from the newborn and breast pump milking should be recommended • Tdap and influenza vaccines can be used during pregnancy	[121,128]
French national college of obstetricians and gynecologists (CNGOF, France)	• Assigning a triage screening area with primary facilities for the screening of symptomatic patients • All the patients and health care professions must wear PPEs • The suspicious patients must be considered positive before the final confirmation with qRT-PCR assay • The pregnant women suspicious to be affected with COVID-19 should be immediately segregated and provided with suitable obstetrical management care facilities • The general non-urgent appointment must be delayed to look after the critical cases of obstetrics • Provision of negative pressure isolation room with ultrasonography facilities for the routine checkup of the pregnant women • Use of corticosteroid therapy based upon the obstetric indications is recommended in the COVID-19 affected pregnant women even before 34 weeks • Telehealth facilities must be recommended for the postpartum visit • The proper hygiene measures must be followed by the mother before feeding or making a contact with the newborn • Breast feeding should be avoided in case the mother is infected with SARS-CoV-2	[[129], [130], [131]]
National Health Commission of the People’s Republic of China	• Thorough examination and diagnosis of mother suspicious for COVID-19 disease • Management of pyrexia and provision of treatment therapies for the affected patients • Newborn delivered by an infected mother must be isolated and observed at least for 14 days and should not be offered with breast feeding	[132]
American College of Obstetricians and Gynecologists (ACOG, US)	• Regular notification of positive cases to the health department after proper testing and screening • The health care workers should wear all protective gears including face mask, gloves etc. • The person with suspicion should be instructed to avoid the contact with social groups and must be confirmed • Antenatal corticosteroids (BMZ) can be used in the patients with COVID-19 disease before 34 weeks • A skilled team of obstetrician, anesthesiologist etc. should be available every time • Due care must be offered to the newborn and the mother after delivery • A halt in the time of delivery can be imposed during late pregnancy to prevent the transmission of infection until the results of test are not available, whereas early pregnancy must be routinely handled • Telehealth facilities can be used for postpartum visit at least for 12 weeks.	[133]
Royal College of Obstetricians and Gynecologists (RCOG, UK)	• Regular screening and use of protective gears • Provision of obstetric emergency facilities • Monitoring of blood parameters and isolation of suspected cases • Routine checkup of the pregnant women by using ultrasonological interventions to monitor the maternal and fetal health status • Proper cleaning of equipments after their use on suspected or positive cases • Isolation of affected patients with the provision of emergency services • Maintenance of proper hygiene measures including hand washing, use of PPEs (FFP3 masks, gloves), and use of breast pumps etc. • Telehealth facilities are recommended to ensure the postpartum visit	[134]
Italian society for Ultrasound in Obstetrics and Gynecology (Italy)	• Follow self-isolation and hygiene measures in asymptomatic patients without any essentiality of PPE • PPE must be used by the symptomatic pregnant women and health care workers accompanying the patients • Use of protective gears like masks and proper hand washing before breast feeding of the newborn • Provision of isolated and designated units for the sample collection and delivery • Isolated rooms should be provided to the mother and babies with at least 60 L/s ventilation • Routine monitoring through ultrasound assessment of asymptomatic mothers • Isolation of symptomatic mothers for 14 days, regular contact through telephones and should be examined after ever 3−4 weeks for the assessment of fetal growth • Decontamination of equipments such as ultrasound machines etc. used on affected pregnant women • Critical symptomatic patients must be admitted to the intensive care units (ICUs)	[130,131]
International Society of Ultrasound in Obstetrics & Gynecology (ISUOG)	• Screening of patients with symptoms in an established triage area • The tested negative samples must be rescreened with qRT-PCR after 24 h and chest CT scan can be used for the confirmation • Critical patients should be admitted to ICU or the rooms with negative pressure facilities • Examination of suspected or recovered patients with the help of ultrasonography must be done after every 2−4 weeks for the assessment of fetal growth and associated post-partum complications • The mode of delivery should be decided on the basis of health status of the patient and spectrum of infection • Water birth and delayed cord clamping should be avoided in critically ill pregnant women • The fetal and placental tissues should be handled carefully by using all the PPEs and personal hygiene guidelines • Feeding through breast pump should be encouraged	[130,135]