Expectant Management of a Critically Ill Pregnant Patient with COVID-19 with Good Maternal and Neonatal Outcomes.
Journal
Case reports in obstetrics and gynecology
ISSN: 2090-6684
Titre abrégé: Case Rep Obstet Gynecol
Pays: United States
ID NLM: 101576454
Informations de publication
Date de publication:
2020
2020
Historique:
received:
06
08
2020
revised:
04
11
2020
accepted:
16
11
2020
entrez:
4
12
2020
pubmed:
5
12
2020
medline:
5
12
2020
Statut:
epublish
Résumé
Coronavirus Disease 2019 (COVID-19) is responsible for a global pandemic that has significantly affected New York City. There is limited data about COVID-19 infection in pregnancy, especially in critically ill patients. A 30-year-old female who presented at 26 weeks gestation with acute severe respiratory distress that required intubation and intensive care unit (ICU) admission. We had a high suspicion of COVID-19 disease despite repeated negative SARS-CoV-2 PCR testing, with eventual positive COVID IgG antibody testing. Through an integration of obstetrical knowledge, critical care, and comparing outcomes from similar cases in the literature, we decided to expectantly manage her pregnancy and did not recommend administration of antenatal steroids. She was extubated after 23 days of mechanical ventilation and recovered from her respiratory illness. She had a full-term spontaneous vaginal delivery of a baby boy at 39 weeks gestation with excellent maternal and fetal outcomes at delivery. In the face of COVID-19, a new disease with unclear maternal and fetal outcomes to date, a collaboration of care teams is essential to navigate through the challenging decisions made, including timing of delivery, treatment options, and administration of steroids. Our paper is unique as there is no other published case report of a critically ill pregnant patient with COVID-19 in which delivery was deferred, and a full recovery was observed, with a vaginal delivery at term.
Sections du résumé
BACKGROUND
BACKGROUND
Coronavirus Disease 2019 (COVID-19) is responsible for a global pandemic that has significantly affected New York City. There is limited data about COVID-19 infection in pregnancy, especially in critically ill patients.
CASE
METHODS
A 30-year-old female who presented at 26 weeks gestation with acute severe respiratory distress that required intubation and intensive care unit (ICU) admission. We had a high suspicion of COVID-19 disease despite repeated negative SARS-CoV-2 PCR testing, with eventual positive COVID IgG antibody testing. Through an integration of obstetrical knowledge, critical care, and comparing outcomes from similar cases in the literature, we decided to expectantly manage her pregnancy and did not recommend administration of antenatal steroids. She was extubated after 23 days of mechanical ventilation and recovered from her respiratory illness. She had a full-term spontaneous vaginal delivery of a baby boy at 39 weeks gestation with excellent maternal and fetal outcomes at delivery.
CONCLUSION
CONCLUSIONS
In the face of COVID-19, a new disease with unclear maternal and fetal outcomes to date, a collaboration of care teams is essential to navigate through the challenging decisions made, including timing of delivery, treatment options, and administration of steroids. Our paper is unique as there is no other published case report of a critically ill pregnant patient with COVID-19 in which delivery was deferred, and a full recovery was observed, with a vaginal delivery at term.
Identifiants
pubmed: 33274091
doi: 10.1155/2020/8891787
pmc: PMC7695992
doi:
Types de publication
Case Reports
Langues
eng
Pagination
8891787Informations de copyright
Copyright © 2020 Farah Alsayyed et al.
Déclaration de conflit d'intérêts
The authors declares that they have no conflicts of interest.
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