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  1. Article ; Online: COVID-19 with severe acute respiratory distress in a pregnant woman leading to preterm caesarean section: A case report.

    Paramanathan, S / Kyng, K J / Laursen, A L / Jensen, L D / Grejs, A M / Jain, D

    Case reports in women's health

    2021  Volume 30, Page(s) e00304

    Abstract: We report the case of a 25-year-old pregnant woman, parity one, at 34 + 2 weeks of gestation ... Three days after delivery, the patient developed severe acute respiratory distress syndrome (ARDS) and ... delivery by caesarean section at 35 + 0 weeks of gestation, with combined spinal and epidural anaesthesia ...

    Abstract We report the case of a 25-year-old pregnant woman, parity one, at 34 + 2 weeks of gestation, with a body mass index of 41 kg/m2 but no other comorbidities. There was a family history of COVID-19 among her one-year-old son, husband, brother, father and mother. She was admitted with chest pain and a nasopharyngeal swap positive for COVID-19. Due to the severity of the infection, a multidisciplinary team of anaesthesiologists, intensivists, obstetricians, neonatologists, and infectious disease specialists recommended delivery by caesarean section at 35 + 0 weeks of gestation, with combined spinal and epidural anaesthesia. Three days after delivery, the patient developed severe acute respiratory distress syndrome (ARDS) and was intubated for 25 days. The neonate was observed in the neonatal intensive care unit and no vertical transmission occurred. This case highlights the importance of the timing of delivery, the need for extended postpartum observation and a beneficial effect of inhaled nitric oxide after delivery for women with COVID-19.
    Language English
    Publishing date 2021-03-08
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2800286-6
    ISSN 2214-9112 ; 2214-9112
    ISSN (online) 2214-9112
    ISSN 2214-9112
    DOI 10.1016/j.crwh.2021.e00304
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Placental pathology in a pregnant woman with severe COVID-19 and successful ECMO treatment: a case report.

    Rosner-Tenerowicz, Anna / Fuchs, Tomasz / Zimmer-Stelmach, Aleksandra / Pomorski, Michał / Trzeszcz, Martyna / Zwierzchowski, Jacek / Zimmer, Mariusz

    BMC pregnancy and childbirth

    2021  Volume 21, Issue 1, Page(s) 760

    Abstract: ... of ECMO in a pregnant woman with acute respiratory distress syndrome in the course of severe COVID-19 ... We report a case of a 38-year-old woman at 27 weeks of gestation treated with multidrug therapy and ECMO ... caesarean section was performed at 29 weeks on ECMO treatment in the ICU. A preterm female newborn was delivered ...

    Abstract Background: Infection with SARS-CoV-2 during pregnancy can lead to a severe condition in the patient, which is challenging for obstetricians and anaesthesiologists. Upon severe COVID-19 and a lack of improvement after multidrug therapy and mechanical ventilation, extracorporeal membrane oxygenation (ECMO) is introduced as the last option. Such treatment is critical in women with very preterm pregnancy when each additional day of the intrauterine stay is vital for the survival of the newborn.
    Case presentation: We report a case of a 38-year-old woman at 27 weeks of gestation treated with multidrug therapy and ECMO. The woman was admitted to the intensive care unit (ICU) with increasing fever, cough and dyspnoea. The course of the pregnancy was uncomplicated. She was otherwise healthy. At admission, she presented with severe dyspnoea, with oxygen saturation (SpO2) of 95% on passive oxygenation, heart rate of 145/min, and blood pressure of 145/90. After confirmation of SARS-CoV-2 infection, she received steroids, remdesivir and convalescent plasma therapy. The foetus was in good condition. No signs of an intrauterine infection were visible. Due to tachypnea of 40/min and SpO2 of 90%, the woman was intubated and mechanically ventilated. Due to circulatory failure, the prothrombotic activity of the coagulation system, further saturation worsening, and poor control of sedation, she was qualified for veno-venous ECMO. An elective caesarean section was performed at 29 weeks on ECMO treatment in the ICU. A preterm female newborn was delivered with an Apgar score of 7 and a birth weight of 1440 g. The newborn had no laboratory or clinical evidence of COVID-19. The placenta showed the following pathological changes: large subchorionic haematoma, maternal vascular malperfusion, marginal cord insertion, and chorangioma.
    Conclusions: This case presents the successful use of ECMO in a pregnant woman with acute respiratory distress syndrome in the course of severe COVID-19. Further research is required to explain the aetiology of placental disorders (e.g., maternal vascular malperfusion lesions or thrombotic influence of COVID-19). ECMO treatment in pregnant women remains challenging; thus, it should be used with caution. Long-term assessment may help to evaluate the safety of the ECMO procedure in pregnant women.
    MeSH term(s) Adult ; COVID-19/diagnosis ; COVID-19/therapy ; Cesarean Section ; Extracorporeal Membrane Oxygenation/methods ; Female ; Humans ; Placenta/pathology ; Placenta/virology ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/therapy ; Pregnancy Trimester, Second ; Treatment Outcome
    Language English
    Publishing date 2021-11-10
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1471-2393
    ISSN (online) 1471-2393
    DOI 10.1186/s12884-021-04228-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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