Universal screening for SARS-CoV-2 in pregnant women should be weighed
by population incidence of the disease
Abstract
Objectives: To evaluate universal SARS-CoV-2 screening in labouring
women in a tertiary hospital in the Netherlands. Women with an unknown
SARS-CoV-2 were treated as COVID-19 positive in theatre. As COVID-19
precautions differed from standard care, this may have contributed to
adverse perinatal outcomes. Methods: Women admitted to the labour- and
pregnancy ward were consecutively asked for COVID-19 symptoms and then
screened for SARS-CoV-2 by PCR. Results: From March 5 2020 to May 13,
283 women without COVID-19 symptoms were screened. One post-symptomatic
woman was excluded from the analysis. 3/ 282 women (1.1%) tested
positive for SARS-CoV-2. In one woman, a pending SARS-CoV-2 test, may
have worsened perinatal asphyxia in her child, and in two other cases
with post-partum haemorrhage the prolonged decision-to intervention
interval may have contributed to more blood loss. Conclusion: Caretakers
should balance the potential additional perinatal risks of alternative
care processes for unscreened SARS-CoV-2 patients in obstetric
emergencies.