Chandigarh: GMCH to use GeneXpert for Covid-19 test before C-sections

Chandigarh: The pressing need for Caesarian section and emergency surgeries has spurred Government Medical College and Hospital (GMCH), Sector 32, to procure GeneXpert diagnostics for Covid-19 test.
Only PGI has this machine which gives the report within 45 minutes and an hour as compared to RT PCR (Reverse Transcription Polymerase chain reaction) test that takes six to eight hours.
“We have GeneXpert for tuberculosis. We do some 14-15 samples under the tuberculosis control national programme. For Covid, the software is different. We do not want to hamper the TB programme, so we are working on procuring another machine only for Covid testing,” said Prof B S Chavan, director-principal, GMCH. He said, “For delivery cases, we cannot wait for Covid reports and have to conduct the surgery without that. However, we follow strict protocols until the reports are out.”
The GeneXpert is 99% accurate molecular diagnostic kit. Unlike the RT PCR test, the GeneXpert is safer as there is no need to deactivate the sample. The GeneXpert does not involve lot of tests and thus within no time results are out. Even for the normal deliveries due to the body fluid secretions, precautions have to be taken. “With the rapid kit, even when we wear PPE kits, we can be at ease once the rapid test is there, as it is very tough to be in those suits,” said a gynaecologist.
As per the ICMR guidelines, all C-sections must get tested for the virus, at least five days prior to the surgery. “We have two slots one in the morning and another in the evening for testing of the C-section deliveries. But in case the surgeries do not fall in that schedule, surgeries are done, and tests reports come later,” said another doctor at the GMCH 32.
Main challenges
C-section takes two more hours due to PPE kits. A coverall is worn to avoid body fluids. There is a dedicated operation theatre for Covid surgeries. But for deliveries, the OTs are regularly fumigated as a routine practice. Also, all the instruments have to be kept for two hours in sodium hypochlorite solution and then autoclaved. This is similar to all other infectious diseases, like HIV and hepatitis.