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. 2021 Jul;3(4):100373.
doi: 10.1016/j.ajogmf.2021.100373. Epub 2021 Apr 6.

Timing of delivery with coronavirus disease 2019 pneumonia requiring intensive care unit admission

Carl H Rose  1 , Michelle A Wyatt  2 , Kavita Narang  2 , Kathleen E Lorenz  2 , Linda M Szymanski  2 , Arthur J Vaught  2
Affiliations

Timing of delivery with coronavirus disease 2019 pneumonia requiring intensive care unit admission

Carl H Rose et al. Am J Obstet Gynecol MFM. 2021 Jul.

Abstract

Approximately 4% of pregnant patients with coronavirus disease 2019 require intensive care unit admission. Given the practical implications of advanced ventilatory and circulatory support techniques, urgent or emergent delivery for nonreassuring fetal status frequently presents a logistical impossibility. This article proposes a protocol for obstetrical management of patients in these situations, emphasizing coordinated preparation among obstetrical, anesthesiology, and intensivist teams for planned preterm delivery at gestational ages when neonatal outcomes are likely to be favorable.

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Figures

Figure
Figure
Timing of delivery in severe or critical COVID-19 cases This flowchart diagram denotes a guideline for the management and delivery of COVID-19 patients requiring intensive care unit admission based on gestational age. COVID-19, coronavirus disease 2019; CXR, chest x-ray; ECMO, extracorporeal membrane oxygenation; FDA, US Food and Drug Administrator; FiO2, fraction of inspired O2; IV, intravenous; NST, non-stress test; PaO2, partial pressure of O2; PEEP, positive end expiratory pressure; SpO2, O2 saturation; V-V, veno-venous. Rose. Delivery timing with coronavirus disease 2019 pneumonia. Am J Obstet Gynecol MFM 2021.
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