**5. Risks to the fetus**

Many studies have shown increased chances of preterm delivery in SARS-CoV2 infected women. Most of these preterm births have been seen to be iatrogenic. Most of the preterm babies have been delivered by caesarean section due to intrauterine foetal distress. Symptomatic women have been found to have increased risk of preterm delivery compared to asymptomatic SARS-CoV2 infected women. Some studies have shown a decrease in mean gestational age at the time of delivery in women who were diagnosed with COVID-19 within 14 days before delivery. One study also reported increased chances of stillbirth in foetuses born to SARS-CoV2 positive mothers [22].

Till date no association has been found with first trimester losses or teratogenicity and COVID-19 infection is not an indication for medical termination of pregnancy. Though this is ever changing situation and we may get more information in future as the evidence is pooled in. Amniocentesis to diagnose fetal infection is also not recommended at present [23].

#### **6. Diagnostic testing for SARS-CoV2 infection in pregnancy**

The criteria for testing pregnant women for SARS-CoV 2 infection remain the same as for general population. Local testing guidelines as per the local, state and regional governments should be followed. Basically, it includes testing symptomatic women, contacts of SARS-CoV2 positive people and those with history of travel.

#### *Pregnancy and COVID-19 DOI: http://dx.doi.org/10.5772/intechopen.98710*

Nasopharyngeal swab is the recommended sample for testing, oropharyngeal swab is also acceptable. Lower respiratory samples are recommended in intubated patients and in those with severe illness and negative nasopharyngeal swabs.

RT-PCR is the most commonly used test in pregnancy. Nucleic Acid Amplification Tests (NAAT) can be used as per availability and regional guidelines.

Rapid antigen tests and serological tests can all be used in pregnancy as per regional protocols and there are no specific considerations for diagnostic testing in pregnancy [24].
