Assisted reproduction emergencies in times of Covid-19
Within our objective of keeping you informed during this global health situation, we wanted to ask the dra Vanessa vergara, gynecologist at IVI Madrid, specialist in RA and Medical Affairs Coordinator, on medical emergencies that exist or may exist during a pandemic, and this is what she has explained to us.
The emergencies in assisted reproduction
The coronavirus pandemic Covid-19 It affects the whole world, it makes us as a society go through difficult moments, moments in which our priorities and perspectives change. We are facing a very complicated situation in which many families have experienced the painful loss of a relative or loved one, and for them, my sincere respect.
Now the most important thing without a doubt is that fewer people are affected by the coronavirus. Second, try to protect the most vulnerable groups from the pandemic as much as possible, such as the elderly and people with coexisting diseases. And third, that our health system has the maximum capacity to treat the sick properly.
For this, we are asked to be at home and not go to the emergency rooms unless strictly necessary.
Fortunately the emergencies in Assisted reproduction They are few, and although it is true that for patients it can be difficult to decide whether a nonspecific symptomatology is an emergency or not, there are situations that you should be clear about and consult as soon as possible.
And how do you know when it is strictly necessary?
It is important to remember that you should consult your doctor when in doubt. Among the warning signs that you must bear in mind to go to an emergency room is an acute pelvic or abdominal pain associated or not bleeding, especially if you are in the condition of monitoring our hormonal levels of human chorionic gonadotropin hormone; heavy bleeding; bleeding associated with dizziness. Respiratory distress is not usually an alarm sign in assisted reproduction, but now in times of the pandemic it is an important reason why a patient should go immediately to an emergency room.
Types of emergencies in assisted reproduction
- Related to the coronavirus
- Depending on the moment of the assisted reproduction treatment in which we are
- Related to pregnancy
- No pregnancy
- Threatened abortion or miscarriage
- Ectopic pregnancy
Emergencies related to the coronavirus
Current evidence indicates that pregnancy is not a risk factor for contracting coronavirus, or for presenting complications. In the case of having any complications, the evolution of the pregnant woman is so far in the published data similar to that of the population without risk factors. However, if you are pregnant of any gestational age and have symptoms related to coronavirus such as fever or cough, you should consult your doctor or the telephones designated for this in your autonomous community or city. If what you present is respiratory distress, you should immediately call the emergency phones or go to an emergency room.
Pregnant women with pre-existing diseases or comorbidities such as high blood pressure, asthma, heart disease, diabetes mellitus may have more possibilities of complications. If you have one of these underlying pathologies, take all possible preventive measures such as staying home, using appropriate masks, gloves, hand washing, and disinfection. In case of symptoms, consult very early to make the correct diagnosis and that the management is quick and timely.
Treatment-related emergencies
In addition to everything related to the coronavirus, there are other types of emergencies that are directly related to the type of treatment and the phase in which we are. For example, infection, bleeding, ovarian torsion are emergencies specifically related to ovarian puncture. This type of emergency is exceptional and a close follow-up by the medical team will avoid complications, especially when the situation of the pandemic allows us to do these procedures again.
Emergencies related to early pregnancy
The most common cause of calls to gynecologists after assisted reproductive treatment is bleeding
Not all bleeds are an emergency, since many pregnancies with normal evolution present bleeding. The opinion of your doctor when explaining the signs and symptoms that you present will be essential.
The first thing we need to know is whether the pregnancy test result is positive or negative and the amount of bleeding. With a negative pregnancy test, the bleeding is caused by the absence of pregnancy. If the pregnancy test is positive, our attitude will depend on the amount of bleeding and your gestational age and whether or not you have had the first gestational ultrasound.
If he bleeding It is abundant and it has been proven that the pregnancy is viable and intrauterine, it is possible that it is a threat of abortion, so you must follow the instructions of your doctor and it is very possible that you do not require any additional intervention.
Most of the time this condition evolves favorably. In some cases, it can evolve to a spontaneous abortion and the warning signs are increased bleeding, colic and expulsion of the remains of pregnancy.
A very important emergency in early pregnancies is the ectopic pregnancy, or gestation outside the uterine cavity. In this type of pregnancy, the embryo implants outside the uterus, most frequently in the fallopian tubes. After performing the assisted reproduction treatment. It is very important that you take the pregnancy test on the day or around the days that you have been indicated. We have three options, which is positive in normal ranges, negative or positive in low ranges. If your doctor informs you that it is positive in low ranges, it is very likely that he will indicate quantitative monitoring of the levels of human chorionic gonadotropin hormone and when he deems it necessary an ultrasound. And if the test is positive in normal ranges, the ultrasound between weeks 5 and 6 of gestation is very important to make sure that the embryo is implanted in the uterine cavity.
Finally, the most important thing is that if you have any questions, you should contact your doctor by phone. If you present any alarm data such as respiratory distress, severe or acute abdominal pain, medical attention should be immediate.
By dra Vanessa vergara
Gynecologist specialist in RA
Medical Coordinator of Medical Affairs
IVI Madrid
