Latest News at the SOGC

SOGC Statement on COVID-19 Vaccination in Pregnancy

Original Statement: December 18, 2020

Reaffirmed: May 4, 2021 

The SOGC acknowledges the need for guidance related to the COVID-19 vaccine and pregnancy and during lactation. We recognize the difficulty facing pregnant individuals and their health care providers at this time, due to the absence of clinical trials that can support evidence-informed recommendations about the COVID-19 vaccine for pregnant and breastfeeding populations. Information related to COVID-19, the impact of the disease on pregnancy and data related to COVID-19 vaccines in development are rapidly evolving. The information contained herein is subject to change as further evidence becomes available.

CONSENSUS STATEMENTS:

  1. Pregnant individuals should be offered vaccination at any time during pregnancy or while breastfeeding if no contraindications exist.
  2. The SOGC supports the use of all available COVID-19 vaccines approved in Canada in any trimester of pregnancy and during breastfeeding in accordance with regional eligibility.
  3. The decision to be vaccinated is based on the individual’s personal values, as well as an understanding that the risk of infection and/or morbidity from COVID-19 outweighs the theorized and undescribed risk of being vaccinated during pregnancy or while breastfeeding. Individuals should not be precluded from vaccination based on pregnancy status or breastfeeding.
  4. Given that pregnant people are at increased risk of morbidity from COVID-19 infection, all pregnant persons should be eligible to receive a COVID-19 vaccination.

Read the statement HERE


May 4, 2021
SOGC Statement on COVID-19 Vaccination in Pregnancy
 

SOGC Statement on the COVID-19 vaccines and rare adverse outcomes of thrombosis associated with low platelets

On behalf of the Infectious Diseases Committee of the SOGC

Date: April 20, 2021

Many healthcare jurisdictions in Canada are facing a third wave of COVID-19 pandemic activity, with some centres rapidly exceeding peak daily case counts, hospital and ICU admissions compared to previous waves of the virus.1, 2 The current Canadian epidemiological trends are, at least in part, driven by low rates of vaccine coverage and circulation of new variants of concern (VOC) of COVID-19 that have been demonstrated to be more transmissible and severe compared to the wild-type virus which predominated previously.3, 4

Pregnancy is a known risk factor for COVID-associated morbidity with data clearly and consistently illustrating that pregnant individuals are at increased risk for hospitalization, ICU admission, mechanical ventilation and death compared to non-pregnant individuals. As a result of these factors, many Canadian centres are facing increased numbers of pregnant individuals infected with COVID-19 being admitted to the hospital and ICU.5 For many pregnant individuals in Canada, the risk of being unvaccinated and susceptible to COVID-19 is substantial.

 The SOGC supports the use of all available COVID-19 vaccines approved in Canada in any trimester of pregnancy and during breastfeeding in accordance with regional eligibility

The four COVID-19 vaccines approved for use in Canada have been demonstrated to be safe and highly effective for preventing serious disease from COVID-19.6, 7 Passive surveillance has been ongoing on a global scale and has not detected adverse pregnancy outcomes related to any COVID-19 vaccinations and emerging evidence shows passive antibody transfer to infants. Given that pregnancy is a demonstrable risk factor for severe COVID-19 disease, and that emerging reports from major Canadian centres have identified an increased burden of disease affecting pregnant individuals, the SOGC recommends that all pregnant people should be eligible to receive a COVID-19 vaccine.       

While international reports have emerged documenting extremely rare events of arterial and venous thrombosis associated with low platelets following the adenovirus vector COVID-19 vaccines (AstraZeneca, COVISHIELD, Janssen COVID-19 vaccines),      these events occur in as few as  1 in every 125,000 to 1 in 1 million people.8, 9, 10, 11  Most cases have occurred in women  <55 years of age, however, this may reflect a workforce gender bias due to the decision to prioritize front-line health care workers, most of whom identify as female. There is no known association between this syndrome and pregnancy and no physiologic basis to increase this risk in pregnancy.

Rare adverse outcomes observed following vaccination with viral vector COVID-19 vaccines should be discussed in context of the disease they are designed to prevent. Specifically, approximately 1 in 10 pregnant individuals will require hospital admission and 1 in 100 pregnant individuals will require intensive care following infection with COVID-19. For some individuals with additional risk factors such as advanced maternal age, obesity and pre-existing medical conditions, the risk of morbidity will be substantially higher. Preventing COVID-19 disease among pregnant individuals must be considered a priority and vaccination is a central tool to protect individuals from severe COVID-19 infection.

References

1.            Public Health Ontario. Ontario covid-19 data tool. Available at https://www.publichealthontario.ca/en/data-and-analysis/infectious-disease/covid-19-data-surveillance/covid-19-data-tool?tab=summary.

2.            Government of Canada. Coronavirus disease (covid-19): Outbreak update. 2020. Available at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html.

3.            Davies NG, Jarvis CI, van Zandvoort K, et al. Increased mortality in community-tested cases of sars-cov-2 lineage b.1.1.7. Nature. 2021. Available at https://doi.org/10.1038/s41586-021-03426-1.

4.            Washington NL, Gangavarapu K, Zeller M, et al. Emergence and rapid transmission of sars-cov-2 b.1.1.7 in the united states. Cell. 2021. Available at https://www.sciencedirect.com/science/article/pii/S0092867421003834.

5.            Sogc statement regarding pregnant woman with covid-19 in icus in ontario. 2021. Available at https://sogc.org/common/Uploaded%20files/Latest%20News/EN_Statement-COVID-19_PregnantWomen.pdf.

6.            National Advisory Committee on Immunization. Recommendations on the use of covid-19 vaccines. 2021. Available at https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines.html.

7.            Government of Canada. Vaccines for covid-19. Available at https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/vaccines.html.

8.            Covid-19 vaccine astrazeneca: Benefits still outweigh the risks despite possible link to rare blood clots with low blood platelets. European Medicines Agency. 2021. Available at https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca-benefits-still-outweigh-risks-despite-possible-link-rare-blood-clots.

9.           Covid-19 vaccine astrazeneca – safety assessment result: The vaccine is safe and effective in the fight against covid-19. Paul-Ehrlich-Institut. 2021. Available at https://www.pei.de/EN/newsroom/hp-news/2021/210319-covid-19-vaccine-astrazeneca-safety-assessment-result-vaccine-safe-and-effective.html;jsessionid=734B77911C71AA454CCA874524CE23E1.intranet211.

10.          Naci rapid response: Recommended use of astrazeneca covid-19 vaccine in younger adults. Health Canada. 2021. Available at https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/rapid-response-recommended-use-astrazeneca-covid-19-vaccine-younger-adults.html.

11.          Centers for Disease Control and Prevention. Recommendation to pause use of johnson & johnson’s janssen covid-19 vaccine. Available at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/JJUpdate.html.

Read the statement HERE

April 21, 2021
SOGC Statement on the COVID-19 vaccines and rare adverse outcomes of thrombosis
 

SOGC statement regarding pregnant women and individuals with COVID-19 in ICUs in Ontario

Date: April 15, 2021
Author: Dr. Jennifer Blake

The Society of Obstetricians and Gynaecologists of Canada (SOGC) released the following statement regarding the alarming situation with pregnant women and individuals with COVID-19 in ICUs in Ontario:

The SOGC calls on the Ontario government and all other provinces to immediately prioritize COVID-19 vaccination for pregnant women and individuals.

All pregnant women and individuals in Canada should be eligible to receive the COVID-19 vaccine.

According to SOGC members, there is currently a daily wave of pregnant women and individuals coming into Ontario ICUs, many requiring ventilators. These women and individuals are getting extremely sick, very quickly.

Pregnant women and individuals who have COVID-19 appear more likely to develop respiratory complications requiring intensive care than women and individuals who aren't pregnant. Providing ventilator support in pregnancy is more challenging, and the risks are greater to both mother and child. Pregnant women and individuals with COVID-19 are more likely to have a premature birth and caesarean delivery, and their babies are more likely to be admitted to a neonatal unit.

Tips for pregnant women and individuals:

• To reduce your risk of infection, Limit contact with others as much as possible

• Avoid contact with anyone who has symptoms

• Wear a cloth face mask in public

• Keep about 2 meters of distance between yourself and others beyond your household

• Focus on taking care of yourself and your baby and don’t hesitate to contact your health care providers if you have any concerns about your physical and mental health

 

For the latest information from the SOGC on COVID-19 and pregnancy, please visit pregnancyinfo.ca/COVID or sogc.org/COVID

For media interview, please contact media@sogc.com

Read the statement HERE


 

April 15, 2021
SOGC statement regarding pregnant women and individuals with COVID-19 in ICUs in Ontario
 

About the SOGC

The SOGC is one of Canada’s oldest national specialty organizations. Established in 1944, the Society’s mission is to promote excellence in the practice of obstetrics and gynaecology and to advance the health of women through leadership, advocacy, collaboration, and education.

The SOGC has over 4,000 members, comprised of obstetricians, gynaecologists, family physicians, nurses, midwives, and allied health professionals working in the field of sexual reproductive health.


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About the JOGC

The Journal of Obstetrics and Gynaecology Canada (JOGC) publishes original research, reviews, case reports, and commentaries by Canadian and international authors, pertinent to readers in Canada and around the world. The Journal covers a wide range of topics in obstetrics and gynaecology and women’s health covering all life stages including the evidence-based Clinical Practice Guidelines, Committee Opinions, and Policy Statements that derive from standing or ad hoc committees of The Society of Obstetricians and Gynaecologists of Canada.

The Journal emphasizes vigorous peer-review and accepts papers in English and French. Abstracts for all papers are available in both languages. JOGC is indexed in Medline.

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ALARM Courses
Improving care provided to women, babies and families during pregnancy, labour and delivery.

ALARM Courses

The SOGC places the utmost importance on improving intrapartum care, from the process to its outcomes. One way to achieve that objective is through offering continuing education programs like the ALARM course (Advances in Labour and Risk Management).

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Welcome and Overview

ALARM was developed by obstetricians/gynaecologists, family physicians, midwives and nurses, who jointly continue to maintain and teach the course. Backed by the SOGC, the ALARM course arose out of our work to improve the care provided to women, babies, and families during pregnancy, labour, and postpartum.

  • The content of the course is evidence-based and incorporates the Canadian practice guidelines, so participants who complete the course gain an understanding of the latest best practices for providing care.
  • The ALARM course objective is to evaluate, update and maintain the competence of obstetricians/gynaecologists, family physicians, midwifes and nurses.
  • This two-day course offers case-based and hands-on workshops.
  • This course is not intended to certify attendees in any procedural skills. It provides education and hands-on experience, but this is not a substitute for clinical exposure and mentorship.
  • The courses have a ratio of approximately 6 participants to 1 faculty member to ensure a highly interactive and educational course.
The ALARM certificate will be awarded only to those who pass the written examination and who attend the course in its entirety.

If you are unable to attend an ALARM course but would like to purchase an ALARM manual, please download this form  and submit it by email to alarm@sogc.com.

Upcoming Courses

Please note that there are currently no in person ALARM courses planned.

We have developed "ALARM Virtual", an independent online study program that is available for registration. For more information or to register, please click here.


If you would like to hold an ALARM course in your community, please contact us at alarm@sogc.com. Please note that a minimum of 12 participants is required.

Should you have any questions about your registration, please do not hesitate to contact us at alarm@sogc.com.

 

Instructor Courses - Overview

The ALARM program would not be possible without the efforts of specialists, physicians, nurses and midwives trained to teach this course to their peers. In order to maintain the quality of this highly recognized program, the ALARM Committee has identified specific requirements for instructors throughout Canada.

In order to be eligible to take the instructor course, you must:
  • Have participated in an ALARM course in the past 4 years
  • Be currently registered as an MD (Family Physician or OB/GYN), Registered Nurse or Registered Midwife
  • Be actively providing intrapartum obstetrical care

If you meet the above requirements and wish to participate in the ALARM instructor course, please submit an application at the link below. Please note, a letter of recommendation from your employer, department head or a current ALARM Course Director is required.


If you are selected, you will be sent a registration link for the course. At this point, you will be able to pay your registration fees ($650 plus applicable taxes for OB/GYN and FP doctors; $500 plus applicable taxes for Registered Nurses and Registered Midwives) and receive access to the course materials.

Your participation at the ALARM instructor course is not a guarantee that you will become a qualified ALARM Instructor. 

To become a qualified ALARM instructor, you must:
  • Complete the Instructor course
  • Teach a course
  • Receive a favourable evaluation from the Course Director

Please note you will be required to teach once every three years to maintain your status as an active instructor following a successful completion of the evaluation process. If you fail to do so, you will have to take another ALARM course or Instructor course to maintain your active instructor status.

Space is limited to 24 participants per course. 

Upcoming Instructor Courses

Richmond, BC - offered in English only

November 8, 2020

Please submit your application if you are interested in participating.

Selected candidates will be invited to register for the course.

Should you have any questions about your application, please do not hesitate to contact us at alarm@sogc.com.

 

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The SOGC is the leading voice in women's health in Canada. We are a strong and vibrant society with an active and growing membership. We are here to support you in providing the best care possible to women in Canada and around the world. That's why so many health care providers have become members of the SOGC. Let us be your partner in practice.

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