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Am J Perinatol 2021; 38(01): 082-087
DOI: 10.1055/s-0040-1718694
Original Article

Maternal-Neonatal Dyad Outcomes of Maternal COVID-19 Requiring Extracorporeal Membrane Support: A Case Series

K. Marie Douglass
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles
,
Katie M. Strobel
2   Division of Neonatology, Department of Pediatrics, University of California, Los Angeles
,
Michael Richley
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles
,
Thalia Mok 
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles
,
Annabelle de St Maurice
3   Division of Infectious Disease, Department of Pediatrics, University of California, Los Angeles
,
Viviana Fajardo
2   Division of Neonatology, Department of Pediatrics, University of California, Los Angeles
,
Andrew T. Young
4   Division of Critical Care, Department of Anesthesia, University of California, Los Angeles
,
Rashmi Rao
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles
,
Lydia Lee
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles
,
Peyman Benharash
5   Divison of Cardiac Surgery, Department of Surgery, University of California, Los Angeles
,
Alison Chu
2   Division of Neonatology, Department of Pediatrics, University of California, Los Angeles
,
Yalda Afshar 
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles
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Abstract

Objective This study aimed to describe two cases of acute respiratory distress syndrome (ARDS) secondary to novel coronavirus disease 2019 (COVID-19) in pregnant women requiring extracorporeal membrane oxygenation (ECMO), and resulting in premature delivery.

Study Design The clinical course of two women hospitalized with ARDS due to COVID-19 care in our intensive care (ICU) is summarized; both participants provided consent to be included in this case series.

Results Both women recovered with no clinical sequelae. Neonatal outcomes were within the realm of expected for prematurity with the exception of coagulopathy. There was no vertical transmission to the neonates.

Conclusion This case series highlights that ECMO is a feasible treatment in the pregnant woman with severe COVID-19 and that delivery can be performed safely on ECMO with no additional risk to the fetus. While ECMO carries its natural risks, it should be considered a viable option during pregnancy and the postpartum period.

Key Points

  • COVID-19 may present with a more severe course in pregnancy.

  • ECMO may be used in pregnant woman with severe COVID-19.

  • Delivery can be performed on ECMO without added fetal risk.

Keywords

severe acute respiratory syndrome-coronavirus-2 - COVID-19 - extracorporeal membrane oxygenation - respiratory distress syndrome - pregnancy


Publication History

Received: 11 September 2020

Accepted: 16 September 2020

Article published online:
17 October 2020

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