Information is ‘very much preliminary’ and further evidence required, HSE says

A number of stillbirths among women with Covid-19 has prompted separate alerts from the Health Service Executive (HSE) and the Institute of Obstetricians.
Pregnant women who notice decreased foetal movements should immediately contact their hospital, the head of the HSE National Women and Infants Programme has advised.
Prof Peter McKenna was responding to the alert issued by the HSE on Thursday after coroners identified coronavirus infection of the placenta as a factor in four stillbirths in January and February.
Prof McKenna told Newstalk Breakfast the information was very much preliminary and further evidence would be required. Pregnant women should continue to avoid acquiring the virus by adhering to public health measures and if they had any concerns they should share them with their hospital where tests would be done, he said.
If the women detected decreased foetal movements it would be prudent to have tests carried out and have them repeated on an ongoing basis, he said.
However, Prof McKenna said it seemed unusual health authorities were only hearing of the issue at this stage, a year into a pandemic. There had been thousands of births in Ireland in the past year and millions throughout the world, he noted, adding if there was a frequency of such incidents it would have come to light in other countries.
While international experience showed it was not unusual for Covid-19 to cause placental infection, stillbirth was an unusual complication, Prof Peter McKenna told The Irish Times.
The fact four stillbirths had occurred in a short time and among the small population of women with Covid-19 had raised concerns, prompting the HSE to issue the alert, he said.
On RTÉ radios Morning Ireland, obstetrician Keelin ODonoghue said the majority of cases of Covid during pregnancy had very good outcomes with most women experiencing only mild symptoms and there had been no maternal deaths as a result of Covid-19.
There could be small clusters of cases of stillbirths by chance, but the data internationally was very reassuring,
The grief of the families who had experienced the stillbirths should be acknowledged, she said.
The HSE alerts have been sent to maternity staff across the country after postmortems identified Covid-19 infection of the placenta as a factor in four recent stillbirths.
On foot of the postmortem findings, two separate coroners took the unusual step of contacting the HSE directly with their concerns. The women had mild or moderate symptoms of Covid-19, but were not very unwell.
The stillbirths, which occurred in the first two months of this year, have yet to be examined at inquests, which are not bound to follow the findings of the postmortems.
Dr Ronan Glynn, deputy chief medical officer said on Thursday evening: We have been made aware of four preliminary reports of stillbirths potentially associated with a condition called Covid Placentitis.
These reports should be interpreted with caution as the coroners have not yet concluded their findings. The HSEs National Women and Infants Programme is aware of and is monitoring the situation and has issued a related notice to obstetric departments.
I would ask that the privacy of all of those affected by this disease continue to be respected at all times.
Two of the stillbirths were included in Nphets daily mortality figures on Thursday evening.
Despite the absence of international evidence for Covid-related stillbirth, it was decided to issue the alert on a precautionary basis.