Perioperative management for cesarean section in COVID-19 patients

Background: Pregnant women and neonates are susceptible populations in many infections. Health-care workers are facing a new challenge as only few data are available on the effect of coronavirus disease 2019 (COVID-19) on pregnancy. The aim of this review was to see the current recommendations regarding the perioperative management of the cesarean section in COVID-19 patients. Methods: We used the keywords of (((((coronavirus [Title/Abstract]) OR (covid-19 [Title/Abstract])) OR (ncov-19 [Title/Abstract])) OR (SARS-cov-2 [Title/Abstract]))) AND (Cesarean [Title/Abstract] or Pregnancy [Title/Abstract]) in the PubMed database to find eligible reports. We studied all titles and abstracts from the search results and removed irrelevant studies that did not comply with our research question. Two authors were assigned to assess the validity and reliability of the studies using the Joanna Briggs Institute's critical appraisal tool. The cutoff point for inclusion was 50% of the total checkmarks in each critical appraisal checklist. Results: We found 16 articles from the PubMed database based on keywords described earlier. After eligibility screening, we found seven eligible articles describing perioperative management of the cesarean section during the COVID-19 pandemic. Conclusion: There is no solid evidence that the cesarean section is protective against the transmission of COVID-19. The use of an appropriate biosafety level-3 protective suits is imperative in managing patients presenting for cesarean section with COVID-19 in an operating room. A negative-pressure environment, both in the operating room and incubator, should be prepared for such cases. Regional anesthesia is the recommended technique, but general anesthesia is preferable in specific maternity conditions.