UNIVERSAL COVID-19 TESTING OF WOMEN ADMITTED FOR CHILD BIRTH

Objective: To determine the incidence of SARS CoV-2 (COVID-19) infection amongst women admitted for child birth and to categorize patients according to disease severity. Study Design: Prospective cohort study. Place and Duration of Study: The study was conducted at Obstetrics Unit of Combined Military Hospital (CMH) Rawalpindi, from 1st May 2020 to 15 June 2020. Methodology: Pregnant patients reporting for childbirth were initially screened and tested for SARS CoV-2 using RT-PCR kits. Primary outcome was number of positive patients and categorization according to severity of disease into asymptomatic, mild, moderate, severe and critical. Screening parameters were symptoms like fever, cough, flu, myalgia, breathing difficulty, gastrointestinal symptoms, travel history and history of contact. Comparison was done between COVID category of asymptomatic and symptomatic patients. Results: Based on PCR testing out of the 525 women giving birth during the study period 43 (8.1%) was COVID positive. Out of the total screened patients 484 (92%) were a symptomatic and 41 (7.8%) were screen positive. 20 (48.7%) of screen positive were PCR positive too. According to disease severity 28 (65%) patients were asymp-tomatic, 10 (23%) mild, 4 (9.3%) moderate and severe (1%). COVID category for screen positive and negative patients was compared and was statistically significant for screen positive patients (p<0.0001). Conclusion: pregnant women with COVID-19 infection are a unique subset of patients. As majority of the patients were asymptomatic and only diagnosed with a positive laboratory test so the recommendation is to do universal testing in this pandemic to prepare for childbirth ina safe environment for patient, neonate and health care workers.