Pregnant woman wins 22-day battle with COVID-19

In a case report presented at Euroanaesthesia, the annual meeting of the European Society of Anesthesiology Intensive Care Units (ESAIC) in Milan, Italy, a Croatian doctor said for the 22-day survival of pregnant COVID-19 patients. I will explain the details of the battle (June 4-6).

31 years old WomanNot vaccinated with COVID, received an emergency C section before being subjected to ECMO (Extracorporeal Membrane Oxygenation), a “last resort” that replaces and cures heart and lung function. ..

The woman developed symptoms of COVID-19 on October 16, 2021 and was positive on October 20, four days later. She was admitted to a university hospital in Split, Croatia on October 26, complaining of shortness of breath, coughing and weakness.

A woman who was 33 weeks gestation at the time of admission did not have an important basis Medical condition..

Her symptoms were mild at first, but quickly progressed and caused concern. Hours after her hospitalization, her breathing deteriorated despite her oxygenation.

An interdisciplinary team led by Us. Professor Sanda Stojanovic Stipic, including an ICU and maternal-fetal medicine doctor, decided to intubate a woman to perform a caesarean section.

“Patients’ condition was rapidly deteriorating,” said Dr. Filip Peris, anesthesiologist and intensive care unit at the University Hospital Split, one of the teams caring for women. ..

“The time it took for the baby to be in the same health was short, so we formed a team to discuss the best things to save the lives of both the mother and the child.

“I decided to do a Caesarean section because my child’s gestational age is quite advanced and my mother’s health is rapidly deteriorating.

“Pregnancy is a stressful time for the body, and childbirth will give the mother time to heal her lungs naturally.”

The boy, weighing 2,380 g (5 lb 4 oz), was healthy and did not require any special medical care.

After the caesarean section, the woman was transferred to the hospital’s COVID ICU, where she was placed on a ventilator. Nevertheless, her lung function ratio (P / F) ratio was 85. Ratios less than 100 are classified as severe ARDS (Acute respiratory stimulus syndrome, A condition in which the alveoli (air sac) begin to fill with fluid because the lungs are severely damaged. )

Her lung function ratio further deteriorated to 70 and she was placed in ECMO.

“The condition of the mother is life-threatening and Mechanical ventilation It wasn’t enough to heal her lungs, “says Dr. Peris. “ECMO was her last chance. We use ECMO 3-5 times a year.

“Her lung function gradually improved and she withdrew from ECMO nine days later. On November 17, after a 22-day survival struggle, the mother and child were discharged home.”

After returning to the hospital and returning to Japan, the woman received extensive physiotherapy and was fully recovered. Her son is also healthy.

Dr. Perris said: “Every step in her fight was closely monitored by a great team of anesthesiologists and ICU nurses. Their team’s efforts were led by Professor Sanda Stojanovic Stipic to win this fight. Was indispensable for hard work. “

Female doctors say pregnancy should not be considered a contraindication to ECMO.They say: “Recent studies show us that Survival rate After using ECMO during pregnancy, it is high in both mother and child. This may be due to the fact that pregnant patients are generally young and healthy. “

Dr. Perris adds: “The risks and benefits of both the mother and the fetus need to be weighed against each other. In this situation, there was a balance between the increased gestational age of the fetus and the rapidly deteriorating clinical condition of the mother.

“Timing is all about medicine. Right timing saves lives.”

The woman was not vaccinated against COVID-19. Dr. Perris said: “Vaccination is very important. It saves lives.

“Studies show that there are no safety concerns for babies born to women vaccinated against COVID-19 during pregnancy.

“We recommend that you vaccinate as soon as possible.”

Provided by the European Anesthesiology and Intensive Care Unit (ESAIC)