Critical respiratory failure in pregnancy complicated with COVID-19: A case report

https://doi.org/10.1016/j.crwh.2021.e00309Get rights and content
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Highlights

  • A COVID-19-positive woman at 34 weeks of gestation presented with respiratory failure.

  • An emergency cesarean section was performed at 34 weeks and 5 days of gestation.

  • The patient's respiratory condition deteriorated the following day.

  • Mechanical ventilation was initiated and was terminated four days after intubation.

  • The case illustrates the unfavorable maternal consequences of COVID-19 infection during pregnancy.

Abstract

The case is presented of a 29-year-old primiparous woman who was COVID-19-positive at 34 weeks of gestation and who developed severe acute respiratory distress syndrome. After a four-day history of fever and mild dyspnea, she was referred to hospital. Ciclesonide, dexamethasone, heparin sodium, and sulbactam/ampicillin were initiated, followed by remdesivir and tocilizumab. On the fourth day after admission (at 34 weeks 5 days of gestation), respiratory failure required ventilator management. An emergency cesarean section was performed and a 2565-g male infant was delivered with an Apgar score of 8/8 and negative COVID-19 status. However, on the following day the patient's respiratory condition deteriorated and mechanical ventilation was initiated. Subsequently, her respiratory condition quickly improved and mechanical ventilation was terminated 4 days after intubation. She was discharged 12 days after cesarean delivery. Our case provides additional evidence that raises concerns regarding the unfavorable maternal consequences of COVID-19 infection during pregnancy.

Keywords

COVID-19
Pneumonia
Pregnancy
Respiratory failure

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