Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, many guidelines have recommended postponing non-emergency operations. However, cesarean sections cannot be indefinitely delayed. Our institution has established a COVID-19 screening strategy for patients undergoing cesarean section. We evaluated the usefulness of this screening strategy. Parturients undergoing cesarean section at our center during the first peak of the COVID-19 outbreak were retrospectively analyzed. Each parturient underwent a questionnaire survey evaluating epidemiological correlation and symptoms at admission. Reverse transcriptase–polymerase chain reaction (RT–PCR) testing and/or chest radiography were performed. In total, 296 parturients underwent cesarean section. All elective and 37 emergency cesarean sections were performed in general operating rooms because they were considered to have a low risk of COVID-19 infection through the screening process. However, 42 emergency cases were performed in negative-pressure operating rooms with full personal protective equipment (PPE) because the RT–PCR results could not be confirmed in a timely manner. None of them were positive for RT–PCR, and there were no cases of nosocomial infection. A comprehensive preoperative screening strategy, including symptomatic and epidemiological correlation, PCR, and/or imaging test, should be performed in patients undergoing cesarian section. Further, cesarean sections in parturients with unconfirmed COVID-19 status should be performed in a negative-pressure operating room with appropriate PPE.
Highlights
Towards the end of August 2020, approximately 25 million people worldwide had been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and 850,000 patients had died in association with coronavirus disease 2019 (COVID-19)
This study demonstrated that an appropriate screening strategy for COVID-19 in patients undergoing cesarean section protects the parturients, neonates, and healthcare providers against exposure to SARS-CoV-2, even during the COVID-19 pandemic
Cesarean sections in parturients with suspected COVID-19 should be conducted in a negative-pressure operating room with appropriate protective equipment (PPE)
Summary
Towards the end of August 2020, approximately 25 million people worldwide had been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and 850,000 patients had died in association with coronavirus disease 2019 (COVID-19). SARS-CoV-2 infection has rapidly spread worldwide, and on 11 March 2020, the World Health Organization declared a global pandemic. Medical experts have made tremendous efforts to develop a medicine for treatment and a vaccine for preventing the transmission of the disease. Despite these efforts, there is still no effective treatment for COVID-19 or vaccine against SARS-CoV-2, a type of RNA virus with error-prone RNA-dependent RNA polymerases and showing frequent mutations [2]
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