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Screening for COVID-19 in asymptomatic pregnant women: Which is better; rectal or oropharyngeal/nasopharyngeal swab?

Year 2021, Volume: 3 Issue: 3, 54 - 59, 30.09.2021
https://doi.org/10.46969/ezh.988147

Abstract

Aim: The aim of the study was to evaluate the incidence of asymptomatic COVID-19 disease in pregnant women with
rectal and oropharyngeal/nasopharyngeal swab to compare the efficacy of two samples.
Material and Method: This prospective cohort study included 234 asymptomatic pregnant women who had undergone
planned cesarean section between May 7 and September 24, 2020 in obstetrics unit of a tertiary care center, in Ankara,
Turkey. The oropharyngeal/nasopharyngeal swab, rectal swab, placental, amniotic fluid, and cord blood samples were
obtained from all participants. The placental, amniotic fluid, and cord blood samples were tested when any of the
oropharyngeal/nasopharyngeal or rectal samples were positive. The real-time reverse transcriptase-polymerase chain
reaction (RT-PCR) test was performed to detect SARS-CoV-2 virus in the samples.
Results: The incidence of the asymptomatic COVID-19 disease was 0.42% (1/234) in the study population. One of 234
oropharyngeal/nasopharyngeal swabs was positive, while none of the rectal swabs including the one positive with
oropharyngeal/nasopharyngeal swab were positive for SARS-CoV-2 virus. The RT-PCR test results of the placental,
amniotic fluid, and cord blood samples of the COVID-positive case were negative.
Conclusion: The incidence of asymptomatic COVID-19 disease in pregnant women who had undergone elective cesarean
delivery was low, in Ankara, Turkey. In asymptomatic pregnant women, oropharyngeal/nasopharyngeal swab was found
to be more useful in detecting COVID-19 disease compared to rectal swab. No evidence was found about the intrauterine
transmission of asymptomatic disease. 

References

  • WHO. Rolling updates on coronavirus disease (COVID-19). 2020. Available at<https://www.who.int/emergencies/diseases/ novel-coronavirus-2019/events-asthey- happen>.Accesion date: December 3, 2020
  • Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323:1061-1069.
  • Wong S, Chow K, Leung T, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 2004; 191:292-297.
  • Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: report of two cases & review of the literature. J Microbiol Immunol Infect 2019; 52:501-503.
  • Ryan GA, Purandare NC, McAuliffe FM, Hod M, Purandare CN. Clinical update on COVID-19 in pregnancy: A review article. J Obstet Gynaecol Res 2020; 46:1235-1245.
  • Damar Çakırca T, Torun A, Hamidanoğlu M, et al. COVID-19 infection in pregnancy: a single center experience with 75 cases. Ginekol Pol 2021; doi: 10.5603/GP.a2021.0118. Epub ahead of print. PMID: 34263921.
  • Fassett MJ, Lurvey LD, Yasumura L,et al. Universal SARS-Cov-2 Screening in Women Admitted for Delivery in a Large Managed Care Organization. Am J Perinatol 2020; 37:1110-1114.
  • Herraiz I, Folgueira D, Villalaín C, Forcén L, Delgado R, Galindo A. Universal screening for SARS-CoV-2 before labor admission during Covid-19 pandemic in Madrid. J Perinat Med 2020; 48:981-984.
  • Prabhu M, Cagino K, Matthews KC,et al. Pregnancy and postpartum outcomes in a universally tested population for SARSCoV-2 in New York City: a prospective cohort study. BJOG.2020; 127:1548-1556.
  • Figueiredo R, Tavares S, Moucho M, Ramalho C. Systematic screening for SARS-CoV-2 in pregnant women admitted for delivery in a Portuguese maternity J Perinat Med 2020; 48:977-980.
  • Yassa M, Yirmibes C, Cavusoglu G,et al. Outcomes of universal SARS-CoV-2 testing program in pregnant women admitted to hospital and the adjuvant role of lung ultrasound in screening: a prospective cohort study. J Matern Fetal Neonatal Med 2020; 33:3820-3826.
  • London V, McLaren R Jr, Atallah F,et al. The Relationship between Status at Presentation and Outcomes among Pregnant Women with COVID-19. Am J Perinatol 2020; 37:991-994.
  • Sutton D, Fuchs K, D'Alton M, Goffman D. Universal Screening for SARS-CoV-2 in Women Admitted for Delivery. N Engl J Med 2020; 382:2163-2164.
  • Chiofalo B, Baiocco E, Mancini E,et al. Practical recommendations for gynecologic surgery during the COVID-19 pandemic. Int J Gynaecol Obstet 2020; 150:146-150.
  • World Health Organization (2020a) Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases. Available at <https://www.who.int/publications/i/item/ laboratory-testing-of-2019-novel-coronavirus-(-2019-ncov)-insuspected-human-cases-interim-guidance-17-january-2020.> Accesion date: December 3, 2020.
  • Vintzileos WS, Muscat J, Hoffmann E, et al. Screening all pregnant women admitted to labor and delivery for the virus responsible for COVID-19. Am J Obstet Gynecol 2020; 223:284-286.
  • GynaecologistsRCoO. Principles for the testing and triage of women seeking maternity care in hospital settings, during the COVID-19 pandemic. 2020.
  • Gagliardi L, Danieli R, Suriano G, et al. Universal SARS-CoV-2 testing of pregnant women admittedfor delivery in two Italian regions. Am J Obstet Gynecol 2020; 223:291-292.
  • Tanacan A, Erol SA, Turgay B, et al. The rate of SARS-CoV-2 positivity in asymptomatic pregnant women admitted to hospital for delivery: Experience of a pandemic center in Turkey. Eur J Obstet Gynecol Reprod Biol 2020; 253:31-34.
  • Dashraath P, Wong JLJ, Lim MXK, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol 2020; 222:521-531.
  • Levy A, Yagil Y, Bursztyn M, Barkalifa R, Scharf S, Yagil C. ACE2 expression and activity are enhanced during pregnancy. Am J Physiol Regul Integr Comp Physiol 2008; 295:R1953-1961.
  • Zhu H, Zhu H, Wang L, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr 2020; 9:51-60.
  • Chen H, Guo JMS, Chen W,et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395:809-815.
  • Pettirosso E, Giles M, Cole S, Rees M. COVID-19 and pregnancy: A review of clinical characteristics, obstetric outcomes and vertical transmission. Aust N Z J Obstet Gynaecol 2020; 60:640-659.
  • Xu H, Zhong L, Deng J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci 2020; 12:8.
  • Holshue ML, DeBolt C, Lindquist S, et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med 2020; 382:929-936.

Asemptomatik gebe kadınlarda COVID-19 taraması: Hangisi daha iyi; rektal mi orofaringeal / nazofaringeal sürüntü mü?

Year 2021, Volume: 3 Issue: 3, 54 - 59, 30.09.2021
https://doi.org/10.46969/ezh.988147

Abstract

Amaç: Çalışmanın amacı, rektal ve orofaringeal / nazofaringeal sürüntü ile gebelerde asemptomatik COVID-19 hastalık
insidansını değerlendirerek iki yöntemin etkinliğini karşılaştırmaktı.
Gereç ve Yöntem: Bu prospektif kohort çalışmasına, Ankara'da üçüncü basamak bir merkezin obstetri ünitesinde 7
Mayıs-24 Eylül 2020 tarihleri arasında planlı sezaryen yapılan 234 asemptomatik gebe dahil edildi. Tüm katılımcılardan
orofaringeal / nazofaringeal sürüntü, rektal sürüntü, plasental, amniyotik sıvı ve kordon kanı örnekleri alındı. Orofaringeal
/ nazofaringeal veya rektal örneklerden herhangi biri pozitif olduğunda plasental, amniyotik sıvı ve kordon kanı örnekleri
test edildi. Örneklerdeki SARS-CoV-2 virüsünü tespit etmek için gerçek zamanlı ters transkriptaz-polimeraz zincir
reaksiyonu (RT-PCR) testi yapıldı.
Bulgular: Asemptomatik COVID-19 hastalık insidansı çalışma popülasyonunda % 0,42 (1/234) idi. 234 orofaringeal /
nazofaringeal sürüntüden biri pozitif iken, orofaringeal / nazofaringeal sürüntü ile pozitif olan dahil rektal sürüntülerin
hiçbiri SARS-CoV-2 virüsü için pozitif değildi. COVID pozitif olgunun plasental, amniyotik sıvı ve kordon kanı örneklerinin
RT-PCR testi sonuçları negatifti.
Sonuç: Ankara'da elektif sezaryen ile doğum yapmış gebelerde asemptomatik COVID-19 hastalığı insidansı düşüktü.
Asemptomatik hamile kadınlarda, orofaringeal / nazofaringeal sürüntü rektal sürüntü ile karşılaştırıldığında COVID-19
hastalığını tespit etmede daha yararlı bulundu. Asemptomatik hastalığın intrauterin geçişine dair bir kanıt bulunamadı.

References

  • WHO. Rolling updates on coronavirus disease (COVID-19). 2020. Available at<https://www.who.int/emergencies/diseases/ novel-coronavirus-2019/events-asthey- happen>.Accesion date: December 3, 2020
  • Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323:1061-1069.
  • Wong S, Chow K, Leung T, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 2004; 191:292-297.
  • Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: report of two cases & review of the literature. J Microbiol Immunol Infect 2019; 52:501-503.
  • Ryan GA, Purandare NC, McAuliffe FM, Hod M, Purandare CN. Clinical update on COVID-19 in pregnancy: A review article. J Obstet Gynaecol Res 2020; 46:1235-1245.
  • Damar Çakırca T, Torun A, Hamidanoğlu M, et al. COVID-19 infection in pregnancy: a single center experience with 75 cases. Ginekol Pol 2021; doi: 10.5603/GP.a2021.0118. Epub ahead of print. PMID: 34263921.
  • Fassett MJ, Lurvey LD, Yasumura L,et al. Universal SARS-Cov-2 Screening in Women Admitted for Delivery in a Large Managed Care Organization. Am J Perinatol 2020; 37:1110-1114.
  • Herraiz I, Folgueira D, Villalaín C, Forcén L, Delgado R, Galindo A. Universal screening for SARS-CoV-2 before labor admission during Covid-19 pandemic in Madrid. J Perinat Med 2020; 48:981-984.
  • Prabhu M, Cagino K, Matthews KC,et al. Pregnancy and postpartum outcomes in a universally tested population for SARSCoV-2 in New York City: a prospective cohort study. BJOG.2020; 127:1548-1556.
  • Figueiredo R, Tavares S, Moucho M, Ramalho C. Systematic screening for SARS-CoV-2 in pregnant women admitted for delivery in a Portuguese maternity J Perinat Med 2020; 48:977-980.
  • Yassa M, Yirmibes C, Cavusoglu G,et al. Outcomes of universal SARS-CoV-2 testing program in pregnant women admitted to hospital and the adjuvant role of lung ultrasound in screening: a prospective cohort study. J Matern Fetal Neonatal Med 2020; 33:3820-3826.
  • London V, McLaren R Jr, Atallah F,et al. The Relationship between Status at Presentation and Outcomes among Pregnant Women with COVID-19. Am J Perinatol 2020; 37:991-994.
  • Sutton D, Fuchs K, D'Alton M, Goffman D. Universal Screening for SARS-CoV-2 in Women Admitted for Delivery. N Engl J Med 2020; 382:2163-2164.
  • Chiofalo B, Baiocco E, Mancini E,et al. Practical recommendations for gynecologic surgery during the COVID-19 pandemic. Int J Gynaecol Obstet 2020; 150:146-150.
  • World Health Organization (2020a) Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases. Available at <https://www.who.int/publications/i/item/ laboratory-testing-of-2019-novel-coronavirus-(-2019-ncov)-insuspected-human-cases-interim-guidance-17-january-2020.> Accesion date: December 3, 2020.
  • Vintzileos WS, Muscat J, Hoffmann E, et al. Screening all pregnant women admitted to labor and delivery for the virus responsible for COVID-19. Am J Obstet Gynecol 2020; 223:284-286.
  • GynaecologistsRCoO. Principles for the testing and triage of women seeking maternity care in hospital settings, during the COVID-19 pandemic. 2020.
  • Gagliardi L, Danieli R, Suriano G, et al. Universal SARS-CoV-2 testing of pregnant women admittedfor delivery in two Italian regions. Am J Obstet Gynecol 2020; 223:291-292.
  • Tanacan A, Erol SA, Turgay B, et al. The rate of SARS-CoV-2 positivity in asymptomatic pregnant women admitted to hospital for delivery: Experience of a pandemic center in Turkey. Eur J Obstet Gynecol Reprod Biol 2020; 253:31-34.
  • Dashraath P, Wong JLJ, Lim MXK, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol 2020; 222:521-531.
  • Levy A, Yagil Y, Bursztyn M, Barkalifa R, Scharf S, Yagil C. ACE2 expression and activity are enhanced during pregnancy. Am J Physiol Regul Integr Comp Physiol 2008; 295:R1953-1961.
  • Zhu H, Zhu H, Wang L, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr 2020; 9:51-60.
  • Chen H, Guo JMS, Chen W,et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395:809-815.
  • Pettirosso E, Giles M, Cole S, Rees M. COVID-19 and pregnancy: A review of clinical characteristics, obstetric outcomes and vertical transmission. Aust N Z J Obstet Gynaecol 2020; 60:640-659.
  • Xu H, Zhong L, Deng J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci 2020; 12:8.
  • Holshue ML, DeBolt C, Lindquist S, et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med 2020; 382:929-936.
There are 26 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Article
Authors

Tuğba Kınay 0000-0001-5340-1025

Funda Akpınar 0000-0001-9388-0374

Yıldız Akdaş Reis This is me 0000-0001-9345-6899

Etem Özkaya This is me 0000-0002-8318-7805

Rıza Durmaz 0000-0001-6561-778X

Yaprak Ustun 0000-0002-1011-3848

Publication Date September 30, 2021
Acceptance Date September 29, 2021
Published in Issue Year 2021 Volume: 3 Issue: 3

Cite

APA Kınay, T., Akpınar, F., Akdaş Reis, Y., Özkaya, E., et al. (2021). Screening for COVID-19 in asymptomatic pregnant women: Which is better; rectal or oropharyngeal/nasopharyngeal swab?. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, 3(3), 54-59. https://doi.org/10.46969/ezh.988147
AMA Kınay T, Akpınar F, Akdaş Reis Y, Özkaya E, Durmaz R, Ustun Y. Screening for COVID-19 in asymptomatic pregnant women: Which is better; rectal or oropharyngeal/nasopharyngeal swab?. Türk Kadın Sağlığı ve Neonatoloji Dergisi. September 2021;3(3):54-59. doi:10.46969/ezh.988147
Chicago Kınay, Tuğba, Funda Akpınar, Yıldız Akdaş Reis, Etem Özkaya, Rıza Durmaz, and Yaprak Ustun. “Screening for COVID-19 in Asymptomatic Pregnant Women: Which Is Better; Rectal or oropharyngeal/Nasopharyngeal Swab?”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi 3, no. 3 (September 2021): 54-59. https://doi.org/10.46969/ezh.988147.
EndNote Kınay T, Akpınar F, Akdaş Reis Y, Özkaya E, Durmaz R, Ustun Y (September 1, 2021) Screening for COVID-19 in asymptomatic pregnant women: Which is better; rectal or oropharyngeal/nasopharyngeal swab?. Türk Kadın Sağlığı ve Neonatoloji Dergisi 3 3 54–59.
IEEE T. Kınay, F. Akpınar, Y. Akdaş Reis, E. Özkaya, R. Durmaz, and Y. Ustun, “Screening for COVID-19 in asymptomatic pregnant women: Which is better; rectal or oropharyngeal/nasopharyngeal swab?”, Türk Kadın Sağlığı ve Neonatoloji Dergisi, vol. 3, no. 3, pp. 54–59, 2021, doi: 10.46969/ezh.988147.
ISNAD Kınay, Tuğba et al. “Screening for COVID-19 in Asymptomatic Pregnant Women: Which Is Better; Rectal or oropharyngeal/Nasopharyngeal Swab?”. Türk Kadın Sağlığı ve Neonatoloji Dergisi 3/3 (September 2021), 54-59. https://doi.org/10.46969/ezh.988147.
JAMA Kınay T, Akpınar F, Akdaş Reis Y, Özkaya E, Durmaz R, Ustun Y. Screening for COVID-19 in asymptomatic pregnant women: Which is better; rectal or oropharyngeal/nasopharyngeal swab?. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2021;3:54–59.
MLA Kınay, Tuğba et al. “Screening for COVID-19 in Asymptomatic Pregnant Women: Which Is Better; Rectal or oropharyngeal/Nasopharyngeal Swab?”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, vol. 3, no. 3, 2021, pp. 54-59, doi:10.46969/ezh.988147.
Vancouver Kınay T, Akpınar F, Akdaş Reis Y, Özkaya E, Durmaz R, Ustun Y. Screening for COVID-19 in asymptomatic pregnant women: Which is better; rectal or oropharyngeal/nasopharyngeal swab?. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2021;3(3):54-9.