Introduction
The role of presymptomatic (SARS-CoV-2 detected before symptom onset) or
asymptomatic (SARS-CoV-2 detected but symptoms never develop) persons in
the COVID-19 pandemic is still under debate [1]. As a result,
symptom-based screening may not be sufficient and PCR testing is often
recommended. The American Society of Anaesthesiologists recommends
universal screening for SARS-CoV-2 by PCR in individuals scheduled for
non-emergency surgery when SARS-CoV-2 prevalence is high, but advices on
a symptom-based strategy when prevalence is low. The rationale is
threefold; first, to protect personnel during aerosolizing airway
management procedures, second to prevent complications after surgery
[2]; and, third, to minimize SARS-CoV-2 spread to patients in
recovery. Previous studies in pre-or asymptomatic women from the USA
reported a SARS-CoV-2 prevalence ranging from 2.9% to 13.5% [3 4].
As labouring women are all at risk to undergo surgery, Amsterdam
University Medical Centers (AUMC) has installed universal screening for
SARS-CoV-2 of all women admitted to our labour- and pregnancy ward since
the pandemic reached the Netherlands. Women with a positive or unknown
SARS-CoV-2 are treated as COVID-19 positive if they are seen in theatre.
This safety measure may lead to an increased decision-to-intervention
time, because of COVID-19 precautions that differ from standard care,
such as an alternative routing in theatre and a potential delay in
preparing for incision. The rationale behind this approach should be
weighed by population incidence of the disease. We aimed to evaluate
this rationale in our setting.