Multiprofessional perinatal care in a pregnant patient with acute respiratory distress syndrome due to COVID-19

BMC Pregnancy Childbirth. 2021 Aug 26;21(1):587. doi: 10.1186/s12884-021-04059-y.

Abstract

Background: The coronavirus disease (COVID-19) pandemic has caused ongoing challenges in health services worldwide. Despite the growing body of literature on COVID-19, reports on perinatal care in COVID-19 cases are limited.

Case presentation: We describe a case of severe acute respiratory distress syndrome (ARDS) in a 36-year-old G5/P2 pregnant woman with morbid obesity, confirmed severe acute respiratory syndrome coronavirus 2 infection, and fulminant respiratory failure. At 28+ 1 gestational weeks, the patient delivered an uninfected newborn. Using ImmunoCAP ISAC® technology, we found no immunoglobulin (Ig) M antibodies, suggesting that no mother-to-child viral transmission occurred during pregnancy or delivery. The maternal respiratory state improved rapidly after delivery; both maternal and neonatal outcomes were encouraging given the early gestational age and fulminant course of respiratory failure in our patient.

Conclusions: The management of ARDS in pregnant women with COVID-19 is complex and requires an individualized, multidisciplinary approach, while considering maternal and fetal outcomes.

Keywords: ARDS; COVID-19; Perinatal care; Pregnancy; SARS-CoV-2; Transmission.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • COVID-19* / complications
  • COVID-19* / diagnosis
  • Cesarean Section / methods*
  • Female
  • Fetal Monitoring / methods
  • Gestational Age
  • Humans
  • Obesity, Morbid / diagnosis
  • Obesity, Morbid / physiopathology
  • Patient Care Team / organization & administration
  • Perinatal Care / methods
  • Pneumonia, Viral* / diagnostic imaging
  • Pneumonia, Viral* / etiology
  • Pregnancy
  • Pregnancy Complications, Infectious* / diagnosis
  • Pregnancy Complications, Infectious* / physiopathology
  • Pregnancy Complications, Infectious* / therapy
  • Pregnancy Complications, Infectious* / virology
  • Pregnancy Outcome
  • Premature Birth* / etiology
  • Premature Birth* / therapy
  • Respiration, Artificial / methods
  • Respiratory Distress Syndrome* / diagnosis
  • Respiratory Distress Syndrome* / etiology
  • Respiratory Distress Syndrome* / physiopathology
  • Respiratory Distress Syndrome* / therapy
  • SARS-CoV-2 / isolation & purification*
  • Treatment Outcome