Sir,
With immense interest we read the article entitled, ‘Coronavirus disease
2019 and pregnancy is déjà vu all over again’ by Rasmussen and
Jamieson.1 The
article briefly describes the problems that were identified in pregnant
women and obstetric service providers during the COVID-19 pandemic. The
authors point to the insufficient attention of health authorities to
these problems. In this regard, they call for a more thorough study of
the impact of coronavirus infection on pregnant women and on providers
of obstetric services, as well as the impact of vaccination on the
course of pregnancy and fetal health, in order to develop
recommendations for the prevention of the next pandemic. To develop
informed solutions, the authors correctly recommend hiring more
providers of obstetric services with in-depth knowledge in the field of
epidemiology, infectious diseases, public health, as well as knowledge
of issues related to the care of pregnant women.1
We would like to thank the authors for their insightful comment. The
article sheds light on the main obstetric problems associated with the
prevention of COVID-19 in pregnant women. But the article does not
address the problem associated with fetal hypoxia in the case of
respiratory obstruction in the mother.
The COVID-19 pandemic has shown that in adults, including pregnant
women, this disease is characterized by the development of atypical
pneumonia, which in a severe stage is complicated by respiratory
obstruction and hypoxia.2,3 This is why COVID-19
increases the risk of fetal intrauterine hypoxia during pregnancy. Fetal
hypoxia is most dangerous in the second half of pregnancy. The fact is
that during this period, with an increase in the duration of pregnancy,
the fetal brain begins to require more and more oxygen. Studies show
that today only forced ventilation of the lungs with oxygen and
extracorporeal membrane oxygenation (ECMO) can normalize the mother’s
blood oxygenation in case of airway obstruction. But traditional lung
ventilation technology does not always provide oxygen delivery to the
alveoli and oxygen absorption into the blood, and ECMO is a very
expensive, inaccessible and dangerous blood oxygenation technology. In
this regard, it is concluded that today there is no alternative to
increasing blood oxygenation due to effective lung ventilation. It is
proposed to increase the efficiency of lung venation by inhaling gaseous
oxygen in combination with an aerosol of alkaline hydrogen
peroxide.4 It has been shown that intra-respiratory
hydrogen peroxide increases the efficiency of forced ventilation of the
lungs due to the immediate dissolution of mucus and pus in the
respiratory tract with their simultaneous transformation into oxygen
foam.
Thus, obstetricians must necessarily be involved in the development of
measures to combat the next pandemic, so that we can prevent coronavirus
infection of a pregnant woman and preserve the fetus in the womb.
Relevant healthcare institutions should recognize that COVID-19
increases the risk of fetal intrauterine hypoxia. Therefore, it is
urgently necessary to improve the technology of artificial lung
ventilation in a pregnant woman in order to exclude hypoxic brain damage
in her fetus.