Early Detection and Diagnosis of Suspected Cases
Early detection of any suspected cases is critically important so that
they can be promptly isolated to minimise potential cross-infection of
the public and our front-line healthcare workers. A set of
questionnaires was adopted from the Ministry of Health Singapore to
screen all pregnant mothers presenting to our centre. These questions
include the presence of fever, cough, acute upper respiratory symptoms,
and recent travel history. Temperature screening is also conducted to
elicit any on-going febrile condition. All these processes are performed
at specified screening posts located at all access points into the
maternity centre and hospital. Mothers who are symptomatic would be
encouraged to wear a surgical mask.
Subsequently, pregnant mothers are then assessed for any acute obstetric
symptoms (such as painful uterine contractions, rupture of amniotic
membranes) for appropriate triaging. Pregnant mothers who may be in
active labour are either transferred to the labour ward or to dedicated
isolation rooms at the Emergency Department for further assessment and
management. This intrapartum management will be highlighted in another
section. Pregnant mothers with non-urgent concerns requiring admission
are transferred to specialised isolation wards with
negatively-pressurised rooms. Multidisciplinary team opinion involving
the infectious disease physician would also be sought. Microbiological
diagnosis was confirmed in our on-site hospital laboratory via
nasopharyngeal swabs. Chest imaging with plain radiograph or Computed
Tomography is safe in pregnancy.(8) COVID-19 infection per se is not an
indication for delivery (9) unless there are maternal indications such
as to improve oxygenation and resuscitation.