3 - Department of Obstetrics and Gynaecology, University Hospital
of Perugia, Perugia , Italy.
From the end of February 2020, SARS- CoV- 2 has dramatically impacted on
Italy, which was the worst affected country in Europe, resulting in
233197 people infected and 33475 deaths.1 Considering
the wide spread of the virus and the frequent lack of symptoms in
pregnant women, since May 1st, we have decided to have universal
screening with nasopharyngeal swabs and the quantitative
polymerase-chain-reaction exam, to detect SARS-CoV-2 infection, all
women who wished to give birth at our hospital. Fatebenefratelli - San
Giovanni Callibita Hospital in Rome, does not have an infectious disease
department, and admitted only women afebrile and without symptoms.
From May 1st to June 30th 2020 a total of 412 pregnant women, who
subsequently delivered their infants to our hospital, were screened with
nasopharyngeal swabs. All women except one were afebrile and without
symptoms on admission. The woman and her partner were tested with a
swab, both of which were negative in the next two checks. However, while
waiting for the result of the test, the couple has been inserted in the
isolation path foreseen by our internal protocol.
One woman, afebrile on admission, developed fever and flu-like symptoms
during labor, so she was moved to the isolated delivery room, to prevent
infection2, according with the internal procedures,
but further tested negative twice for SARS- CoV- 2. Another woman,
afebrile on admission, developed postpartum fever and was treated with
antibiotics for presumed postpartum endometritis
Of the 242 nasopharyngeal swabs obtained, none was positive for
SARS-CoV-2.
None test turned positive during the hospitalization.
Our experience of universal screening for SARS-CoV-2 in pregnant
patients delivering at our hospital showed that the incidence of virus
in our cohort (0%) was lower compared to Rome general population (10,04
X 10000) till 05/28/2020.3
Even in case of false negative results of tests to detect SARS-CoV-2, we
didn’t register any fever or symptoms in women screened during
hospitalization, or cases of obstetricians or midwives or other
professionals, being in contact, infected throughout the month of May
2020.
There are various reasons that can justify this result. One of these was
reported by Manfredi et al, which assessed how a lockdown declared
without delays, in southern and central Italy, unlike in Lombardy,
thanks to the cooperation between the Government and the opposition,
could influence the achievement of adequate control results, that was
reached in a shorter period in southern and central Italy, if compared
to US and other European countries.4 Unlike MERS,
where complications and adverse outcomes were more common among pregnant
women. 5 Another reason is Covid-19 infection probably
affects and runs less severely in pregnant women. Nonetheless, further
studies are needed to better understand the virus behavior in pregnant
women.