The patient had tested positive on TreuNat; it is the first case of child delivery of a pregnant COVID-19 patient in state
Gangtok: STNM Hospital took a big stride amid COVID surge when a pregnant positive patient successfully delivered a healthy baby girl on Tuesday morning. The 33-year-old patient from Pani House in Gangtok was admitted from Central Referral Hospital to Sir Thutob Namgyal Memorial Hospital on Monday evening.
She had two COVID tests under Rapid Antigen Testing conducted upon her, with one faring as positive and the other being negative. STNM remained unsure about the COVID positive stand and conducted a Truenat test, last night which later tested positive.
Speaking with EastMojo on the grand success of the Hospital administering a Caesarean surgery upon a COVID positive pregnant lady and successfully delivering a baby, Obstetrician Dr. Chimi Palmu Theengh stated, "I was hoping that the patient would be negative, as she had no history of contact, nor was she placed in any of the quarantine facility or from a containment zone. She had been regularly visiting the Gynaecology and Obstetrics Department in CRH Manipal, where she was seeking consultation from. We cannot be sure where she came in contact with the virus, the probability could be from the Hospital itself upon visit. The contact tracing may be underway."
As soon as she tested positive, she was shifted to the Gynaecology and Obstetrics ward under the COVID wing on the 7th floor of the Hospital. Due care was taken on non-mixture with other COVID patients.
"Under pregnancy, the pregnant patient developed Gestational Diabetes, but she was taking medicine for the same. After 30 years of age, it is taken as a high-risk pregnancy, which is termed as Elderly Pregnancy Primi with GDM. We conducted all the investigation upon her arrival, late last night. There was consideration for blood to be arranged as well by today morning", stated Dr. Theengh.
Around 6-7 am her water broke, leading to the Specialists conducting Caesarean surgery this morning. "Around 8:53 am, we delivered a healthy female child weighing 3.3 kg. She is on her mother’s side with breastfeeding also being allowed. Post-operation, she is responding well with an oral diet also being initiated. Surgery wise everything went well, but her being a Gestational Diabetes patient, we will have to keep a strict watch", informed the Doctor.
On the concern about the baby being positive or not, the doctor asserted, "There is no guarantee that there will be a maternal transmission of the virus. The baby is bound to stay with her mother for a longer period, with her needing breastfeeding. We have urged the mother to strictly wear gloves while touching the baby along with masks, whenever she is breastfeeding the baby. She has to maintain personal hygiene. After some days, it depends on whether to conduct a test for the baby or not. As it is very difficult to collect the swab from the baby. As the swabs are big and adult-oriented, so normally we refrain from taking a sample of the baby". It remains in the hands of the pediatrician whether to conduct a test or not upon discharge and depends on the baby's symptoms, it was informed.
On the concern of baby being COVID positive through breastfeeding from the mother, the doctor maintained, "We do not have data so far that such transmission has happened. If we carry out formula feeding for the baby, there are chances of other issues like diarrhea. There have been no studies so far anywhere, on the mother-baby transmission on COVID after pregnancy delivery. It all depends on how she responds in the days to come. A per our protocol, breastfeeding has not been barred, it has to be given".
As per the rules under obstetrics, the patient must be kept for 5 days before being discharged, provided her home quarantine facility is up to the standards of COVID protocol currently, informed the health professional. "There were a few suspect COVID pregnancy cases that had come up before. It was mostly followed for pregnancy cases coming from containment areas. Thankfully, there were no cases of COVID pregnancy before this case and this does stand as the first COVID positive pregnancy delivery in the State".
The mother in contention is an asymptomatic patient, who is doing well with no cough or fever and is comfortable, informed the Health officials.
On the struggle and pressure of delivering from a COVID positive patient, the operating surgeon stated, "When it is normal delivery there is no hassle or trouble, but with this being the first COVID pregnancy delivery, there is a lot of difference. Surgery is done in a closed room and we fiddle with the blood of the patient. There are high chances of exposure to the virus. At the back of our mind, we were a little scared as well. We were careful about the layers of PPE suit we were wearing today, or any part of our skin is exposed, there should not be any breach through the suit. It took us 30 minutes just to don the PPE suit. By the time the anesthetics were administered to the patient, we were already perspiring. With goggles it was blurred vision, hence we carried out with patience and with a lot of cautiousness", informed the doctor. The patient was in her surgical gown and a mask.
The team of doctors who carried out the delivery included, Operating Surgeon Dr. Chimi Palmu Theengh, Anaesthetists Dr. Gyamtso Bhutia and Dr. Abhishek Gurung, Paediatrician Dr. Ruth Yonzon, Staff nurses Lassangmith Lepcha, Malati Subba, Ranjeeta Ghataney, Prasish Tamang, Operation Theatre technician Praveen Lama, and Bhim Kumar Tamang, ward attendant Pem Lhamu Sherpa and housekeeping staff Kailash Rai.