{"id":2633,"date":"2020-04-29T15:56:46","date_gmt":"2020-04-29T10:26:46","guid":{"rendered":"https:\/\/yashivf.com\/blog\/?p=2633"},"modified":"2020-04-29T15:56:54","modified_gmt":"2020-04-29T10:26:54","slug":"testing-for-covid-19-coronavirus-infection-in-pregnancy","status":"publish","type":"post","link":"https:\/\/yashivf.com\/blog\/testing-for-covid-19-coronavirus-infection-in-pregnancy\/","title":{"rendered":"Testing for COVID-19 (Coronavirus Infection) In Pregnancy"},"content":{"rendered":"\n<p>The nodal body for testing and treatment of Covid-19 in India is The Department Of Health Research, at the Indian Council Of Medical Research (ICMR), which has updated the &#8216;Strategy for COVID19 testing for pregnant women in India (Version 1) <strong>on 20th April 2020.<\/strong><\/p>\n\n\n\n<p>All clinicians and institutes dealing with pregnant ladies are required to carry out Testing as per the ICMR testing strategy (<a href=\"https:\/\/icmr.nic.in\/content\/covid-19\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/icmr.nic.in\/content\/covid-19<\/a>).<\/p>\n\n\n\n<p>Pregnant women who are residents of containment zones or clusters, who&nbsp; present in labour or are likely to deliver within&nbsp; subsequent 5 days,&nbsp; need to be tested even if they do not show any symptoms of Covid-19 (asymptomatic).&nbsp; This applies equally to those pregnant ladies evacuated from from hotspot districts or members of large migration gatherings.&nbsp;<\/p>\n\n\n\n<p>Testing of asymptomatic pregnant women should be performed at the health facilities where they were scheduled to deliver.<\/p>\n\n\n\n<p>The facility is required to make all arrangements to collect and transfer samples to authorised testing facilities.&nbsp;<\/p>\n\n\n\n<p>Lack of testing facilities can not be a justification for referring the Women to higher facility, please note.<\/p>\n\n\n\n<p>The testing is done according&nbsp;to&nbsp;the same&nbsp;criteria&nbsp;as employed for evaluating&nbsp;all normal&nbsp;adults. Testing for Covid-19 in pregnant women&nbsp;is to be performed only on&nbsp; those who<\/p>\n\n\n\n<ol><li>have acute respiratory&nbsp;illness<\/li><li>history of &nbsp;exposure, travel, contact,&nbsp;<\/li><li>are themselves Health Care Workers or&nbsp;<\/li><li>those requiring hospitalisation&nbsp;<\/li><\/ol>\n\n\n\n<p>Another category is pregnant women who do not fall in any of the above categories but present with&nbsp; Severe Acute Respiratory disease (SARI) .<\/p>\n\n\n\n<p>Recommended Test&nbsp;Techniques&nbsp;and Facilities\u2013 All institutes must observe the Government of India Guidelines on testing.&nbsp;<\/p>\n\n\n\n<p>Other investigations \u2013 supportive investigations&nbsp;include&nbsp;blood&nbsp;research&nbsp;for&nbsp;contamination&nbsp;and systemic&nbsp;assessment&nbsp;and imaging&nbsp;by way of&nbsp;CT&nbsp;scan&nbsp;with&nbsp;the precaution of abdominal&nbsp;shielding.<\/p>\n\n\n\n<h4><strong>Test methods and facilities&nbsp;<\/strong><\/h4>\n\n\n\n<p><strong>Sampling strategy:<\/strong><\/p>\n\n\n\n<p>The Center for Disease Control &amp; Prevention (CDC) recommends a nasopharyngeal swab specimen to be collected for COVID-19 test.&nbsp;<\/p>\n\n\n\n<p>An oropharyngeal swab may additionally be recommended but is not essential. However, if it is collected, the oropharyngeal swab should be placed in the same container as the nasopharyngeal specimen.&nbsp;<\/p>\n\n\n\n<p>Sputum is to be collected only if the&nbsp; patient has a productive cough.&nbsp;<\/p>\n\n\n\n<p><strong>Testing methodology:<\/strong><\/p>\n\n\n\n<p>As of now, detection of COVID-19 is done by a technique known as &#8216;Reverse-transcription polymerase chain reaction&#8217; (RT-PCR). The test can only be performed from a center which is authorized by the Central or State government.&nbsp;<\/p>\n\n\n\n<p>Currently there are 114 ICMR approved public laboratories where the test can be done.&nbsp;<\/p>\n\n\n\n<p>As far as private laboratories are concerned, the government has authorised some private labs&nbsp; to conducted Covid-19 tests from 22 March 2020.&nbsp;<\/p>\n\n\n\n<p>The cost of the tests<\/p>\n\n\n\n<p>This has been capped in private labs at Rs 4500\/-.&nbsp;<\/p>\n\n\n\n<p>Lead Time For Results to be available<\/p>\n\n\n\n<p>Reports generally take at least 24 hour to become available.&nbsp;<\/p>\n\n\n\n<p>Test is to be repeated only if clinically warranted.&nbsp;<\/p>\n\n\n\n<h4><strong>Rapid Testing Facilities<\/strong><\/h4>\n\n\n\n<p>Molecular diagnostic tests that can give results in 2-3 hours may be available soon across the country. Currently the supply is limited to few areas&nbsp; and centers only.<\/p>\n\n\n\n<h4><strong>Points To Be Noted<\/strong><\/h4>\n\n\n\n<p>False negative tests (Patient is infected with Covid-19 but the test is negative) are known to occur.&nbsp; The occurrence rate is between 10-30% even if two serial swabs are evaluated by the RT-PCR technique.&nbsp;<\/p>\n\n\n\n<h4><strong>More Reliable Testing Method<\/strong><\/h4>\n\n\n\n<p>Serological testing for the presence of antibodies to the Covid-19 infection and Nucleic Acid Ampli\uf001cation Test (NAAT) are more advanced tests that may be available in the near future. NAAT is a gold standard test but it is more expensive and in this method there is an inherent risk of multiplication of viral particles.&nbsp;<\/p>\n\n\n\n<p>Serological testing, on the other hand, is faster and cheaper. On a large scale, as at a population level, serological testing to evaluate the prevalence of Covid-19 infection in that population is a more feasible method.&nbsp;<\/p>\n\n\n\n<p>Also, after 3 weeks of infection, the serology would give the correct diagnosis as compared to the RT-PCR, which would be negative.<\/p>\n\n\n\n<h4><strong>Other investigations&nbsp;<\/strong><\/h4>\n\n\n\n<p>X-rays and CT scans are the other investigations likely to be asked for in patients suspected of and also those with confirmed Covid-19 infections. For pregnant women undergoing these radiological investigations an abdominal shield must be provided to protect the foetus from exposure to harmful radiation.&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The nodal body for testing and treatment of Covid-19 in India is The Department Of Health Research, at the Indian Council Of Medical Research (ICMR), which has updated the &#8216;Strategy for COVID19 testing for pregnant women in India (Version 1) on 20th April 2020. All clinicians and institutes dealing with pregnant ladies are required to [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":2639,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[53],"tags":[],"_links":{"self":[{"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/posts\/2633"}],"collection":[{"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/comments?post=2633"}],"version-history":[{"count":1,"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/posts\/2633\/revisions"}],"predecessor-version":[{"id":2634,"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/posts\/2633\/revisions\/2634"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/media\/2639"}],"wp:attachment":[{"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/media?parent=2633"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/categories?post=2633"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/yashivf.com\/blog\/wp-json\/wp\/v2\/tags?post=2633"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}