Objective To explore the prevalence of asymptomatic SARS-CoV-2 in the maternity population. Study design Newham University Hospital based in East London serving a population with the highest death rate secondary to SARS-CoV-2 in the UK, commenced universal screening of all admissions to the Maternity Unit from 22nd April to 5th May, 2020. A proforma was created to capture key patient demographics, indication for admission and presence of SARS-CoV-2 related symptoms at the point of presentation. Results A total of 180 women with a mean age of 29.9 (SD 7.4) years, at a median gestation of 39 (IQR 37 + 1–40 + 3) weeks underwent universal screening with nasopharyngeal PCR swabs during the two-week period of the study. BAME identity or parity was not associated with the likelihood of a positive result. Seven women (3.9 %, 1.6–7.8) were tested positive for SARS-CoV-2, of whom 6 (3.3 %, 1.2–7.1) were asymptomatic; 85.7 % (42.1–99.6) of the SARS-CoV-2 positive women were asymptomatic. The sensitivity of symptom-driven testing was 14.3 % (0.36–57.87) and specificity was 91.86 % (86.72–95.48) with a positive predictive value of 6.67 % (1.08–31.95) and a negative predictive value of 96.34 % (95.10–97.28). Conclusion The prevalence of SARS-CoV-2 in the maternity population served by Newham University Hospital was 3.9 %, four weeks after lockdown. Of the women who were found to be SARS-CoV-2 positive, a high proportion (87.9 %) were asymptomatic. These findings support the need for universal testing to enable targeted isolation and robust infectious control measures to mitigate outbreaks of SARS-CoV-2 in maternity units.

Electronic Fetal Heart Rate (FHR) monitoring is recommended to assess fetal well-being during labour in high risk pregnancies. This Cardiotocograph (CTG) monitoring relies on the ultrasound technology with the limitation of signal loss in 15% to 40% of the cases [1]. In the earlier versions of these CTG monitors, fetal heart tracings were generally of reasonable quality with many artefacts and some degree of occasional large signal noise. Subsequent models were improved by signal modulation and autocorrelation. Although, these new methodologies of signal processing have reduced the signal loss, the issues of inadvertent monitoring of the maternal heart rate as fetal heart rate and inaccurate evaluations of baseline fetal heart rate (i.e. doubling or halving) continue to pose difficulties during intrapartum fetal heart rate monitoring.