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COVID-19 and Women’s Health

Universal Screening: What Percent of Women Admitted to L&D are Positive for SARS-CoV-2?

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PURPOSE:

  • Sutton et al. (NEJM, 2020) sought to determine how many pregnant women admitted for delivery were positive for SARS-CoV-2, based on a universal screening program initiated in New York City, a high prevalence COVID-19 ‘hot spot’

METHODS:

  • Retrospective review (March 22 and April 4, 2020)
  • Setting
    • 2 Affiliated hospitals in New York City
  • Participants
    • All pregnant women admitted for delivery
    • All women screened at time of admission for COVID-19 using nasopharyngeal swabs (quantitative polymerase-chain-reaction)

RESULTS:

  • 215 pregnant women admitted to L&D
  • Symptomatic: 1.9% (n=4)
    • 100% screened
    • Positive for SARS-CoV-2: 100% (4/4)
  • Asymptomic: 98.1% (n=211)
    • 99.5% screening (210/211)
    • Positive for SARS-CoV-2: 13.7% (n=29)
    • 1 patient who was initially negative became symptomatic postpartum at which time repeat testing was positive
  • COVID-19 positive patients who were asymptomatic on admission
    • Percent of screen positive patients who were asymptomatic on admission: 87.9% (29/33)
    • Of those asymptomatic but COVID-19 positive
      • Median length of stay: 2 days
      • Fever developed in 10% (n=3) prior to postpartum discharge
        • Two patients received antibiotics for endomyometritis
        • 1 patient received supportive care for COVID-19

CONCLUSION:

  • Most patients admitted for delivery with COVID-19 were asymptomatic
  • Potential benefits of universal screening can help
    • Determine which patients will benefit from isolation practices
    • Direct bed assignments
    • Guide neonatal care and PPE use
  • The authors further state that

Although this prevalence has limited generalizability to geographic regions with lower rates of infection, it underscores the risk of Covid-19 among asymptomatic obstetrical patients

Moreover, the true prevalence of infection may be underreported because of false negative results of tests to detect SARS-CoV-2

Learn More – Primary Sources:

Universal Screening for SARS-CoV-2 in Women Admitted for Delivery

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Related ObG Topics:

ACOG COVID-19 FAQs for Obstetrical Care
COVID-19 & Pregnancy Cases: Updated Primary Scientific Reports with Professor Jim Thornton
Coronavirus and Pregnancy: CDC Guidance and Professional Recommendations

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