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.