A 20-year old pregnant woman was rushed to Sassoon general hospital (SGH) as a case of premature rupture of membranes for four hours from a hospital in Bhosari. The woman had to be operated on and so was tested for Covid-19 using the rapid antigen detection kit in which she tested negative.

She had neither symptoms related to Covid-19 nor any history of contact with any patient. However, after delivery when the RT-PCR tests came forward it was found that the patient was positive for Covid-19 infection. Although the operation was conducted with full precaution, such incidents raise questions on the accuracy of the tests which are often the final decision for ground-level health workers.

The woman who came from Bhosari was admitted on July 23.

Dr. Shilpa Naik, associate professor at the hospital said, “The rapid antigen test is done to isolate the patient, but its sensitivity is lesser if compared to RT-PCR and so we did send a sample for RT-PCR. For both the tests we took the nasal sample. One she tested negative in the antigen test, we proceeded with the operation. All necessary precautions were taken inside the operation theatre assuming the patient to be a Covid-19 suspect including wearing of PPE kits and also following social distancing norms.”

Dr Naik further said, “She delivered in the afternoon at 2pm, a healthy male baby. The baby’s swab test was negative for the Covid-19 infection. However, there was a rare complication post-delivery. After delivery, the uterus everted out of the introitus (III degree uterine inversion was seen). The patient had sudden tachycardia and hypotension so we gave immediate resuscitation and manual correction reposition of the uterus. So basically the uterus was inverted inside out which is a rare event as it happens once in 2,000 to 50, 000 deliveries. To put it in perspective, in my 20-year career at the hospital I have only seen three incidences of uterine inversion.”

Due to vigilant monitoring, quick diagnosis, and immediate manual repositioning of the uterus, major complications of uterine inversion like neurogenic and haemorrhagic shock and severe blood loss could be prevented, Dr Naik added.

“However, we cannot yet connect Covid-19 to these complications because a lot needs to be studied in placenta pathology to understand how much does Covid-19 affect a pregnant woman and the foetus,” she said.

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