Nosocomial Covid-19 Infection in Women Undergoing Elective Cesarean Sections: A prospective cohort study

Nizam, Aaron; Nimaroff, Michael L.; Menzin, Andrew W.; Goldberg, Gary L.; Miyara, Santiago J.; Molmenti, Ernesto

BACKGROUND: The Covid-19 pandemic placed Obstetricians in the difficult position of continuing to perform elective cesarean sections without knowledge of the risk of nosocomial spread of the Covid-19 virus. OBJECTIVES: To determine the nosocomial infection rate in women undergoing elective cesarean section at two academic institutions. DESIGN: This non-randomized prospective cohort trial evaluated patients undergoing elective cesarean section during the reopening phase of the Covid-19 pandemic in New York State at two large volume Labor and Delivery Units. Eligible patients with negative pre-operative Covid-19 reverse transcriptase-polymerase chain reaction test and IgG antibody test were re-tested 6-9 days after discharge. The primary objective was the Covid-19 test conversion rate defined as a positive PCR test after discharge with a negative pre-operative test. This was used as a proxy for the nosocomial infection rate. RESULTS: 136 patients were screened for participation. Two patients tested positive for Covid-19 on preoperative testing and 25 declined to participate. 111 patients consented to participate and 96 underwent both preoperative and postoperative testing. No patients with a negative PCR test pre-operatively had a positive PCR test for the Covid-19 virus postoperatively. CONCLUSIONS: With a strict and methodical perioperative and postpartum protocol, we can limit nosocomial Covid-19 infections in women undergoing elective cesarean section.