In recent months, COVID-19 has spread rapidly throughout the world and our country. For expectant mothers, there will be multiple interactions with the health care system when consulting their obstetricians, and eventually, most are admitted to the hospital for delivery. This triggers the question of whether there is a requirement for expecting mothers to be tested and swabbed for COVID-19.
There is no recommendation from any authorities on a routine or universal swab for screening of COVID-19 among expecting mothers. However, many healthcare centres, especially private medical centres in Malaysia, now require a pre-admission COVID-19 swab test to be performed for screening purposes prior to any procedures done including deliveries. This is generally to avoid any unwanted exposure and transmission of the COVID-19 virus among maternity patients as well as their babies and healthcare staff which may be debilitating or fatal if contracted.
The timing for the swab test as well as the type of swab (either COVID-19 Polymerase chain reaction, RTK-antigen or others) will depend on the protocol requirement as well as the availability of the test in each centre. Alternatively, another approach that can be implemented is to screen the expecting mothers based on their exposure and risk history and decide on the need for a swab test and the type of swab test based on this. This way may be more economical although there is a risk of missing a positive case when admitting patients to the hospitals.
Hence, testing protocols and eligibility for the test will vary depending on where the expecting mother lives and the place where she goes for her antenatal check-up and delivery. However, WHO recommends that pregnant women with symptoms of COVID-19, should be prioritized for testing. In this situation, if they turn out to be positive for COVID-19, they may need specialized in-patient care. If a mother’s swab is positive, then the baby will require a swab as well and may need admission to the neonatal unit in isolation for observation of any symptoms and complications.
In general, despite the burden of the additional cost of universal testing, the potential benefits of this approach will allow medical centres to determine if isolation practices and bed assignments, special neonatal care and use of personal protective equipment is necessary. Access to these assessments provides an opportunity to protect mothers, babies, and health care teams during these challenging times.
By Dr Ida Lilywaty Md Latar,
Obstetrics and Gynaecology (O&G),
Pantai Hospital Cheras (PHC)
