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.