The coronavirus disease 2019 (COVID-19) continues to ravage the globe, significantly affecting vulnerable groups like people with chronic illnesses and pregnant women. Unlike early in the pandemic, recent evidence indicates that COVID-19 causes various complications in pregnancy like preterm birth and preeclampsia. However, it is unclear how COVID-19 precisely interplays with pregnancy, and which trimester the infection is most detrimental is variable. Some pregnancy-related complications, such as preeclampsia and eclampsia, share similar pathophysiological mechanisms and clinical features to COVID-19; as a result, they present a diagnostic challenge, with one condition being mistaken for the other, leading to poor pregnancy outcomes. We discovered COVID-19 among asymptomatic mothers who later developed complications and those who initially presented with complications based on our experiences performing routine COVID-19 tests, which were published in various case reports. These patients were mostly in their third trimester, and we believe the outcomes would have been worse if COVID-19 had not been detected early and treated promptly. Therefore, this clinical opinion is structured to show how COVID-19 affects pregnancy and which trimester the infection is most detrimental based on the available data to support routine testing of COVID-19 among pregnant women and to maximize benefits while minimizing costs.
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