Severe COVID-19 Pneumonia in a 30-Year-Old Woman in the 36th Week of Pregnancy Treated with Postpartum Extracorporeal Membrane Oxygenation

Takayama, Watatu; Endo, Akira; Yoshii, Junichiro; Arai, Hirokuni; Oi, Keiji; Nagaoka, Eiki; Toyama, Satoshi; Yamamoto, Hiroto; Uchida, Tatsuo; Otomo, Yasuhiro

doi:10.12659/ajcr.927521

Cited by 14 publications

(22 citation statements)

References 23 publications

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“…Most of the contemporary literature regarding obstetric COVID-19 falls into the realm of either epidemiologic reports describing maternal and neonatal outcomes or case reports describing management in a variety of clinical circumstances. 8,9 Preliminary data from China suggested that preterm delivery via cesarean section was almost three-fold more common in COVID-19-infected patients, although specific distinction into indicated or spontaneous subcategories was not reported. 10 Subsequent metanalysis has shown an overall preterm delivery rate of approximately 29%, while another group found a cesarean delivery rate of 89%.…”

Section: Existing Evidence Maternalmentioning

confidence: 99%

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

Rose¹,

Wyatt²,

Narang³

et al. 2021

American Journal of Obstetrics & Gynecology MFM

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Approximately 4% of pregnant patients with COVID-19 infection require intensive care unit admission. Given the practical implications of advanced ventilatory and circulatory support techniques, urgent or emergent delivery for non-reassuring fetal status frequently represents a logistical impossibility. This manuscript proposes a protocol for obstetrical management of patients in these situations, emphasizing coordinated preparation between obstetric, anesthesiology, and intensivist teams, with planned preterm delivery at gestational ages when neonatal outcomes are likely to be favorable.

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Section: Existing Evidence Maternalmentioning

confidence: 99%

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

Rose¹,

Wyatt²,

Narang³

et al. 2021

American Journal of Obstetrics & Gynecology MFM

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“…Few studies on the relationship between DIC and respiratory failure not involving amniotic fluid embolism have been conducted 38 . Hypertensive disorders have been shown to account for most cases of obstetric acute respiratory distress syndrome (ARDS) or pulmonary edema 39 – 41 and DIC, excluding lung viral infections such as COVID-19 42 ; however, there have been no studies on the relationship between DIC and ARDS in obstetric hypertensive disorders. Monroe Karetzky reported that noncardiogenic pulmonary edema is the most common cause of respiratory failure in the peripartum period 43 .…”

Section: Discussionmentioning

confidence: 99%

Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China

Zhao

Zhang

et al. 2021

Sci Rep

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We aimed to determine disseminated intravascular coagulation (DIC)-associated organ failure and underlying diseases based on data from three ICU wards in tertiary hospitals in China from 2008 to 2016. The diagnosis of DIC was confirmed by an International Society of Thrombosis and Hemostasis score greater than or equal to 5. The maternal outcomes included the changes in organ function 24 h after ICU admission. The durations of hospital stay and ICU stay were recorded as secondary outcomes. Among 297 ICU admissions (median Sequential Organ Failure Assessment score, 4) for obstetric diseases, there were 87 DIC cases, with an estimated DIC incidence of 87 per 87,580 deliveries. Postpartum hemorrhage was the leading disease associated with DIC (71, 81.6%), followed by hypertensive disorders (27, 31.0%), sepsis (15, 17.2%), acute fatty liver of pregnancy (11, 12.6%) and amniotic fluid embolism (10, 11.5%). Compared with patients without DIC, those with DIC had higher rates of multiple organ dysfunction syndrome/death (27.6% vs 4.8%, p = 0.000), organ failure (36.8% vs 24.3%, p = 0.029), among which organ failure included acute renal failure (32.2% vs 10.0%, p = 0.000), respiratory failure (16.1% vs 8.6%, p = 0.057), disturbance of consciousness (12.6% vs 2.4%, p = 0.000) and DIC group also had higher rates of massive transfusion (52.9% vs 21.9%, p = 0.000), hysterectomy (32.2% vs 15.7%, p = 0.001), longer ICU (4 days vs 2 days, p = 0.000) and hospital stays (14 days vs 11 days, p = 0.005). DIC and amniotic fluid embolism were independent risk factors for organ failure in patients admitted to the ICU. Postpartum hemorrhage was the leading cause of DIC associated organ failure in obstetrics admitted to the ICU. The control of obstetric bleeding in a timely manner may improve obstetric prognoses.

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“…Bei relevanter Thrombozytopenie ( < 50 Gpt/l) ist die Pausierung aufgrund steigender Blutungsrisiken, auch hinsichtlich geburtshilflicher und anästhesiologischer Aspekte, angeraten [66]. Weiterführende Therapieoptionen, wie das Prone positioning [384,385], Plasma-Exchance-Verfahren [386], ECMO-Therapie [387][388][389][390], die Appliktion von intravenösem Immunglobulin IVIG [391] oder Rekonvaleszentenplasma [392,393] stellen im Individualfall mögliche diskutable Optionen dar. det werden [29,30].…”

Section: Vertikale Transmissionunclassified

“…Weiterführende Therapieoptionen, wie das Prone positioning 384 385 , Plasma-Exchance-Verfahren 386 , ECMO-Therapie 387 388 389 390 , die Appliktion von intravenösem Immunglobulin IVIG 391 oder Rekonvaleszentenplasma 392 393 stellen im Individualfall mögliche diskutable Optionen dar.…”

Section: Hintergrundinformationen Zu Sars-cov-2 Und Covid-19 In Der S...unclassified

Empfehlungen zu SARS-CoV-2/COVID-19 in Schwangerschaft, Geburt und Wochenbett – Update November 2021 (Langfassung)

Zöllkau

Hagenbeck

Hecher

et al. 2021

Z Geburtshilfe Neonatol

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ZusammenfassungSeit Beginn der SARS-CoV-2-Pandemie haben die Deutsche Gesellschaft für Gynäkologie und Geburtshilfe und die Gesellschaft für Peri-/Neonatalmedizin Empfehlungen zum Umgang mit SARS-CoV-2-positiven Schwangerschaften und Neugeborenen veröffentlicht und wiederholt aktualisiert. Als Weiterführung der bestehenden Empfehlungen werden in dem aktuellen Update Schlüsselfragen zur prä-, peri- und postnatalen Versorgung von Schwangeren, Gebärenden, Wöchnerinnen, Stillenden mit SARS-CoV-2 und COVID-19 sowie deren Un- oder Neugeborenen auf der Grundlage von Veröffentlichungen bis zum September 2021 behandelt. Die Empfehlungen und Stellungnahmen wurden sorgfältig aus den aktuell verfügbaren wissenschaftlichen Daten abgeleitet und anschließend im Expertenkonsens verabschiedet. Dieser Leitfaden – hier in der Langfassung vorliegend – soll eine Hilfe für die klinische Entscheidungsfindung darstellen. Die Auslegung und therapeutische Verantwortung obliegen weiterhin dem betreuenden medizinischen Team vor Ort, dessen Entscheidungen durch diese Empfehlungen unterstützt werden sollen. Aufgrund der raschen Dynamik neuer Erkenntnisse kann eine Anpassung erforderlich sein. Die Empfehlungen werden durch die Zustimmung der Fachgesellschaften getragen: Deutsche Gesellschaft für Perinatale Medizin (DGPM), Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), Deutsche Gesellschaft für Pränatal- und Geburtsmedizin (DGPGM), Deutsche Gesellschaft für Pädiatrische Infektiologie (DGPI), Gesellschaft für Neonatologie und Pädiatrische Intensivmedizin (GNPI).

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Severe COVID-19 Pneumonia in a 30-Year-Old Woman in the 36th Week of Pregnancy Treated with Postpartum Extracorporeal Membrane Oxygenation

Cited by 14 publications

References 23 publications

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

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

Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China

Empfehlungen zu SARS-CoV-2/COVID-19 in Schwangerschaft, Geburt und Wochenbett – Update November 2021 (Langfassung)

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