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09.03.2022 | COVID-19 | News and Views Zur Zeit gratis

Perinatal outcomes of pregnant women with severe COVID-19 requiring extracorporeal membrane oxygenation (ECMO): a case series and literature review

verfasst von: Sara Clemenza, Sara Zullino, Chiara Vacca, Serena Simeone, Caterina Serena, Marianna Pina Rambaldi, Serena Ottanelli, Silvia Vannuccini, Manuela Bonizzoli, Adriano Peris, Massimo Micaglio, Felice Petraglia, Federico Mecacci

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2022

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Abstract

Purpose

Pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have a higher risk of hospitalization, admission to intensive care unit (ICU) and invasive ventilation, and of acute respiratory distress syndrome (ARDS). In case of ARDS and critical severe coronavirus disease 2019 (COVID-19), the use of extracorporeal membrane oxygenation (ECMO) is recommended when other respiratory support strategies (oxygen insufflation, non-invasive ventilation [NIV], invasive ventilation through an endotracheal tube) are insufficient. However, available data on ECMO in pregnant and postpartum women with critical COVID-19 are very limited.

Methods

A case series of three critically ill pregnant women who required ECMO support for COVID-19 in pregnancy and/or in the postpartum period.

Results

The first patient tested positive for COVID-19 during the second trimester, she developed ARDS and required ECMO for 38 days. She was discharged in good general conditions and a cesarean-section [CS] at term was performed for obstetric indication. The second patient developed COVID-19-related ARDS at 28 weeks of gestation. During ECMO, she experienced a precipitous vaginal delivery at 31 weeks and 6 days of gestation. She was discharged 1 month later in good general conditions. The third patient, an obese 43-year-old woman, tested positive at 38 weeks and 2 days of gestation. Because of the worsening of clinical condition, a CS was performed, and she underwent ECMO. 143 days after the CS, she died because of sepsis and multiple organ failure (MOF). Thrombosis, hemorrhage and infections were the main complications among our patients. Neonatal outcomes have been positive.

Conclusion

ECMO should be considered a life-saving therapy for pregnant women with severe COVID-19.

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Titel: Perinatal outcomes of pregnant women with severe COVID-19 requiring extracorporeal membrane oxygenation (ECMO): a case series and literature review
verfasst von: Sara Clemenza
Sara Zullino
Chiara Vacca
Serena Simeone
Caterina Serena
Marianna Pina Rambaldi
Serena Ottanelli
Silvia Vannuccini
Manuela Bonizzoli
Adriano Peris
Massimo Micaglio
Felice Petraglia
Federico Mecacci
Publikationsdatum: 09.03.2022
Verlag: Springer Berlin Heidelberg
Schlagwort: COVID-19
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 5/2022
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-022-06479-3

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Perinatal outcomes of pregnant women with severe COVID-19 requiring extracorporeal membrane oxygenation (ECMO): a case series and literature review