✔ 孕婦感染SARS-CoV-2的症狀和其他患者相似。對於疑似或確診新型冠狀病毒的孕婦需
要按上述說明治療與處置，同時考慮懷孕時的生理變化。
✔ 對於疑似、確診或因接觸史須被隔離之孕婦，需提供包括產科、新生兒科與孕婦心理 支持系統之全方位照顧。確診孕婦康復後，即可接受一般產前與周產期醫療照顧。
✔ 相較於未感染SARS-CoV-2之育齡婦女，有症狀之SARS-CoV-2確診孕婦演變為重症之風 險較高，特別是當孕婦本身有其他潛在疾病時。
✔ 相較於未感染或無症狀感染SARS-CoV-2之孕婦，有症狀之SARS-CoV-2確診孕婦早產之 風險較高，且新生兒死產與低體重風險較高。
✔ 在非臨床試驗情境下使用實驗性治療方案時，需按母親潛在的獲益和治療對胎兒的安 全性，逐案進行利弊分析，並諮詢產科專家和倫理委員會。
✔ 若需緊急分娩和終止妊娠，必須考慮以下因素：孕齡、母親的狀況、胎兒的穩定性。
必須諮詢產科、新生兒科和加護治療（視孕婦狀況而定）的專家。
✔ 關於懷孕患者處置，建議參閱「台灣婦產科醫學會」相關指引。
參考文獻
1. Chen et al. Clinical characteristics and intrauterine vertical transmission potential of COVID- 19 infection in nine pregnant women: a retrospective review of medical records.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736（20）30360-3/fulltext
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2. Rasmussen et al. Coronavirus Disease 2019 （COVID-19） and Pregnancy: What obstetricians need to know. https://www.ajog.org/article/S0002-9378（20）30197- 6/fulltext
3. Lu et al. Coronavirus disease （COVID-19） and neonate: What neonatologist need to know. https://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.25740
4. Zaigham et al. Maternal and perinatal outcomes with COVID-19: a systemic review of 108 pregnancies. https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.13867
5. Chen et al. Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China.
https://www.nejm.org/doi/full/10.1056/NEJMc2009226?query=RP
6. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory- Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020. https://www.cdc.gov/mmwr/volumes/69/wr/mm6944e3.htm?s_cid=mm6944e3_w 7. Allotey et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of
coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis.
https://www.bmj.com/content/370/bmj.m3320.long
8. Adhikari et al. Pregnancy Outcomes Among Women With and Without Severe Acute Respiratory Syndrome Coronavirus 2 Infection.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkope n.2020.29256?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_li nks&utm_term=111920
9. Woodworth et al. Birth and Infant Outcomes Following Laboratory-Confirmed SARS-CoV-2 Infection in Pregnancy — SET-NET, 16 Jurisdictions, March 29–October 14, 2020.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6944e2.htm?s_cid=mm6944e2_w 10. Coronavirus (COVID-19) Infection in Pregnancy.
https://www.rcog.org.uk/media/xsubnsma/2022-03-07-coronavirus-covid-19-infection-in- pregnancy-v15.pdf
11. Torri et al. Disease Severity and Perinatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 (COVID-19).
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https://journals.lww.com/greenjournal/Fulltext/2021/04000/Disease_Severity_and_Perinat al_Outcomes_of.3.aspx
12. Chmielewska et al. Effects of the COVID-19 pandemic on maternal and perinatal outcomes:
a systematic review and meta-analysis.
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00079-6/fulltext#%20 13. COVID-19相關說明及確診產婦生產經驗分享.
https://www.taog.org.tw/news_contain_page.php?SN=175
14. 台灣婦產科醫學會SARS-CoV-2流行期孕產婦臨床處置暫行指引(第五版) https://www.taog.org.tw/news_contain_page.php?SN=220
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十四、
處置產婦與新生兒的特別注意事項✔ 少數確診孕婦其羊水、胎盤、新生兒咽喉拭子與母乳中曾由PCR檢出病毒，亦有確診 孕婦之新生兒於出生24小時內即為SARS-CoV-2 PCR陽性，新生兒可能於子宮內、產程 中，或產後接觸而感染SARS-CoV-2。
✔ 目前證據顯示，SARS-CoV-2陽性產婦的新生兒，出生1–3天內SARS-CoV-2 PCR檢驗陽 性之比率約為1.6–2%。
！考量新生兒感染風險，建議與產婦充分討論後，將疑似或確診產婦暫時與新生兒隔離，
直至產婦達到解除隔離條件為止。若醫療院所設備許可且產婦同意採行母嬰同室，則須遵 循感染管制原則。
✔ 關於產婦與新生兒處置，建議參閱「台灣婦產科醫學會」、「台灣兒科醫學會」與「台 灣新生兒科醫學會」相關指引。
參考文獻
1. Zeng et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2763787
2. Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019
（COVID-19） in Inpatient Obstetric Healthcare Settings.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare- guidance.html
3. Detection of SARS-COV-2 in Placental and Fetal Membrane Samples.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205635/
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4. Severe COVID-19 during Pregnancy and Possible Vertical Transmission.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356080/
5. Vertical Transmission of SARS-CoV-2: What is the Optimal Definition? https://www.thieme- connect.com/products/ejournals/pdf/10.1055/s-0040-1712457.pdf
6. Transplacental transmission of SARS-CoV-2 infection.
https://www.nature.com/articles/s41467-020-17436-6 7. Detection of SARS-CoV-2 in human breastmilk.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31181-8/fulltext 8. Evaluation of Rooming-in Practice for Neonates Born to Mothers With Severe Acute
Respiratory Syndrome Coronavirus 2 Infection in Italy.
https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2020.
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9. General Information Regarding Pregnant Individuals and COVID-19.
https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel- coronavirus-2019
10. 台灣婦產科醫學會SARS-CoV-2流行期孕產婦臨床處置暫行指引(第五版) https://www.taog.org.tw/news_contain_page.php?SN=220
11. 對於確診/懷疑COVID-19母親之新生兒的照護注意事項
https://www.pediatr.org.tw/member/bedside_info.asp?id=29 12. 新生兒COVID-19感染臨床處置注意事項
http://www.tsn-neonatology.com/health/content.php?type=&id=19&pageNo=1&continue=Y 13. 台灣新生兒科醫學會SARS-CoV-2流行期確診或懷疑COVID-19產婦之新生兒照護原則
指引 http://www.tsn-neonatology.com/news/content.php?id=635
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