Successful management of severe acute respiratory distress syndrome due to COVID-19 with extracorporeal membrane oxygenation during mid-trimester of pregnancy

Tambawala, Zenab Yusuf; Hakim, Zeinabsadat Tabatabaei; Hamza, Lama Khalid; Rayes, Maryam Al

doi:10.1136/bcr-2020-240823

Cited by 18 publications

(19 citation statements)

References 7 publications

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“…Potential maternal benefits of expediting delivery must be carefully balanced against the risk to the fetus of iatrogenic prematurity. Multiple case reports describe women with severe covid-19 infection in the first and second trimesters receiving critical care, including mechanical ventilation and ECMO, and recovering to complete the remainder of their pregnancies 8586. In cases where preterm birth is considered necessary, magnesium sulfate therapy should be administered for fetal neuroprotection up to 29+6 weeks’ gestation and considered up to 33+6 weeks’ gestation 87.…”

Section: Obstetric Carementioning

confidence: 99%

Diagnosis and management of covid-19 in pregnancy

Nana

Hodson

Lucas

et al. 2022

BMJ

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Pregnant women with covid-19 are at greater risk of severe disease than their non-pregnant peers, and yet they are frequently denied investigations or treatments because of unfounded concerns about risk to the fetus. The basic principles of diagnosing and managing covid-19 are the same as for non-pregnant patients, and a multidisciplinary, expert team approach is essential to ensure optimal care. During pregnancy, treatment with corticosteroids should be modified to use non-fluorinated glucocorticoids. Il-6 inhibitors and monoclonal antibodies, together with specific antiviral therapies, may also be considered. Prophylaxis against venous thromboembolism is important. Women may require respiratory support with oxygen, non-invasive ventilation, ventilation in a prone position (either awake or during invasive ventilation), intubation and ventilation, and extracorporeal membrane oxygenation (ECMO). Pregnancy is not a contraindication for any of these supportive therapies, and the criteria for providing them are the same as in the general population. Decisions regarding timing, place, and mode of delivery should be taken with a multidisciplinary team including obstetricians, physicians, anesthetists, and intensivists experienced in the care of covid-19 in pregnancy. Ideally these decisions should take place in consultation with centers that have experience and expertise in all these specialties.

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Section: Obstetric Carementioning

confidence: 99%

Diagnosis and management of covid-19 in pregnancy

Nana

Hodson

Lucas

et al. 2022

BMJ

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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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“…In most of these cases, the pregnancy was advanced enough that a cesarean section extraction of a viable fetus could be performed 1,4,5 . One report describes a single patient who kept her child until term despite ECMO, 6 but infection with SARS‐CoV‐2 had occurred at 26 weeks of pregnancy. Here we describe here the earliest fetal‐age case so far reported, at 18 weeks' gestation.…”

Section: Introductionmentioning

confidence: 99%

Low fetal age is not a contraindication for extracorporeal membranous oxygenation in COVID‐19‐related ARDS

Zalle¹,

Barthelemy²,

Piperata

et al. 2022

Journal of Cardiac Surgery

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Introduction The coronavirus disease 2019 (COVID‐19) causes a small proportion of patients to be admitted to intensive care units, where they sometimes require extracorporeal membrane oxygenation (ECMO). The literature on pregnant women with COVID‐19 who require ECMO is sparse. Case report We describe here the earliest‐fetal‐age pregnant patient with COVID‐19 who underwent ECMO yet reported, who kept her child while under close follow‐up with magnetic resonance imagery and ultrasound. Conclusion The management of acute respiratory distress syndrome (ARDS) in pregnant women, including ARDS secondary to COVID‐19 and those cases which are not eligible for fetal delivery, may benefit from the assistance of ECMO even in the early pregnancy.

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Successful management of severe acute respiratory distress syndrome due to COVID-19 with extracorporeal membrane oxygenation during mid-trimester of pregnancy

Cited by 18 publications

References 7 publications

Diagnosis and management of covid-19 in pregnancy

Diagnosis and management of covid-19 in pregnancy

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

Low fetal age is not a contraindication for extracorporeal membranous oxygenation in COVID‐19‐related ARDS

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