Delivery in asymptomatic Italian woman with SARS-CoV-2 infection.

On March 30, 2020, a 33-year-old Italian pregnant at 40 weeks of gestation was admitted to the hospital on Department of Obstetrics and Gynecology in good health due to childbirth induction. From 24 to 28 March she experienced minor symptoms of rhinitis, anosmia and dysgeusia. A Floqswabs oropharyngeal swab in Copan universal transport medium (Copan Italia S.p.A., Brescia, Italy) was obtained on March 29 and resulted positive for SARS-CoV-2 on real-time reverse-transcription PCR assay, performed according to the Berlin/Cornan protocol. 4 Patient’s husband has been affected by fever, cough and dyspnea for 7 days, with confirmed SARS-CoV-2 three days before wife hospital admission. According to the parity, the weeks of gestation and her positivity to SARS-C-V-2 delivery was planned. On admission, the physical examination revealed a body temperature of 36.6°C, a blood pressure of 110/70 mmHg, pulse rate of 86 beats per minute, respiratory rate of 16 breath per minute and oxygen saturation of 100% in ambient air. Lung auscultation was unremarkable and arterial blood gases were regular, with pH 7,45, pCO2 30.3 mm/Hg, and pO2 110 mm/Hg. Laboratory tests were within the normal range, except for elevated fibrinogen and d-dimer (Table 1). The woman was admitted in a restricted COVIDdelivery room area, in the presence of two midwives and one gynecologist, according to the internal hospital protocol. They enter the area together with the patient, leaving the room only after delivery or at the end of the work shift. Outside the area, another gynecologist and an anesthesiologist were on call for every need. Our obstetric-hospital COVID area is composed of two bedrooms for the patients, one delivery room, and one surgical room. The surgical room is provided of a surgical bed ready for the radiologic procedure. In the case of postpartum hemorrhage, the patient can be treated in the same area. A fully equipped neonatal islet was placed in the operating room for assistance to the newborn and any advanced neonatal resuscitation. Since hospitalization, the patient was given surgical mask, and droplet and contact precaution were started. 5