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. 2021 Sep;14(3):170-176.
doi: 10.1177/1753495X21990213. Epub 2021 Mar 9.

Severe and critical COVID-19 in pregnancy: A case series from Montreal

Marie-Julie Trahan  1 , Isabelle Malhamé  2   3 , Cristina Mitric  1 , Camille Simard  2 , Jed Lipes  2   4   5 , Haim A Abenhaim  6
Affiliations

Severe and critical COVID-19 in pregnancy: A case series from Montreal

Marie-Julie Trahan et al. Obstet Med. 2021 Sep.

Abstract

Background: Optimal obstetric management for women with coronavirus disease (COVID-19) is not known. We describe the management of six pregnant women requiring in-hospital care for severe COVID-19.

Methods: A retrospective chart review was conducted to identify pregnant women who tested positive for Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) between 15 March and 30 June 2020. A subset of women meeting criteria for severe COVID-19 was included.

Results: Four women required non-invasive supplemental oxygen therapy and two required mechanical ventilation. Four women were discharged from hospital undelivered and two required preterm delivery. One woman had a pulmonary embolism, and two required re-admission for worsening symptoms.

Conclusion: Management of pregnant women with severe COVID-19 is complex and should involve multidisciplinary expertise. Avoiding early delivery may be a safe option. We recommend an individualized approach to care, including careful consideration of the expected risks and benefits of expectant obstetric management versus delivery.

Keywords: COVID-19; coronavirus; critical care; delivery; intensive care unit; mechanical ventilation; pregnancy; supplemental oxygen symptoms; thromboprophylaxis.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Lapinsky SE. Acute respiratory failure in pregnancy. Obstet Med 2015; 8: 126–132. - PMC - PubMed
    1. Lapinsky SE. Management of acute respiratory failure in pregnancy. Semin Respir Crit Care Med 2017; 38: 201–207. - PubMed
    1. Callaghan WM, Creanga AA, Jamieson DJ. Pregnancy-related mortality resulting from Influenza in the United States during the 2009-2010 pandemic. Obstet Gynecol 2015; 126: 486–490. - PMC - PubMed
    1. Mor G, Cardenas I. The immune system in pregnancy: a unique complexity. Am J Reprod Immunol 2010; 63: 425–433. - PMC - PubMed
    1. Di Mascio DD, Khalil AA, Saccone G, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020. May; 2: 100107. - PMC - PubMed

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