A 33-year-old pregnant female at 30 weeks gestation was referred from another hospital with fever, rhinitis, productive cough, progressive dyspnoea and myalgia of 1 week duration. Her past history was unremarkable except for a history of abortion and congenital scoliosis. She was conscious, oriented, tachycardic [HR 140/min], BP of 120-70 mmHg, in respiratory distress [Tachypnoeic with a RR of 40/min, room air SpO2 52% and had B/L crepitations]. She was started on NIV. Her ABG revealed respiratory acidosis with severe hypoxia (7.30/ 48/ 35/ 22). Chest x-ray showed bilateral non-homogenous opacities. A provisional diagnosis of severe ARDS due to probable viral pneumonia was made. She was intubated and mechanically ventilated [PCV, FiO2 1.0, RR 24, PEEP 20]. Treatment was started with empirical antibiotics (Meropenem, linezolid, azithromycin), antiviral (Oseltamivir), steroids for foetal lung maturity and other supportive medications.
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