Obstetric and intensive-care strategies in a high-risk pregnancy with critical respiratory failure due to COVID-19: A case report

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Kolkova, ZuzanaLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital (author)

Obstetric and intensive-care strategies in a high-risk pregnancy with critical respiratory failure due to COVID-19 : A case report

Article/chapterEnglish2020

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Elsevier BV,2020
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LIBRIS-ID:oai:DiVA.org:uu-522047
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-522047URI
https://lup.lub.lu.se/record/66d06f6e-fb61-4541-9e67-44a23ed2e739URI
https://doi.org/10.1016/j.crwh.2020.e00240DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Kolkova, Zuzana Bjurstrom, Martin F Lansberg, John-Kalle Svedas, Eimantas Hamer, Maria Andrada Hansson, Stefan R Herbst, Andreas Zaigham, Mehreen eng Case Reports Netherlands 2020/07/28 Case Rep Womens Health. 2020 Jul 8;27:e00240. doi: 10.1016/j.crwh.2020.e00240. eCollection 2020 Jul.
BACKGROUND: With the disease burden increasing daily, there is a lack of evidence regarding the impact of COVID-19 in pregnancy. Healthy pregnant women are still not regarded as a susceptible group despite physiological changes that make pregnant women more vulnerable to severe infection. However, high-risk pregnancies may be associated with severe COVID-19 disease with respiratory failure, as outlined in this report. We discuss the importance of timely delivery and antenatal steroid administration in a critically ill patient. CASE: A 27-year-old pregnant woman (gravida 2, para 1) with type I diabetes, morbid obesity, hypothyroidism and a previous Caesarean section presented with critical respiratory failure secondary to COVID-19 at 32 weeks of gestation. A preterm emergency Caesarean section was performed, after steroid treatment for foetal lung maturation. The patient benefited from prone positioning; however, transient acute renal injury, rhabdomyolysis and sepsis led to prolonged intensive care and mechanical ventilation for 30 days. The baby had an uncomplicated recovery. CONCLUSION: COVID-19 infection in high-risk pregnancies may result in severe maternal and neonatal outcomes such as critical respiratory failure requiring mechanical ventilation and premature termination of the pregnancy. Antenatal steroids may be of benefit for foetal lung maturation but should not delay delivery in severe cases.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reproduktionsmedicin och gynekologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Obstetrics, Gynaecology and Reproductive Medicine hsv//eng
Covid-19
Coronavirus
Intubation
Pregnancy
SARS-CoV-2

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Bjurstrom, M. F.Skåne University Hospital(Swepub:uu)marbj610 (author)
Länsberg, John-KalleLund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)jo3126la (author)
Svedas, E.Lund University (author)
Hamer, M. A.Skåne University Hospital (author)
Hansson, Stefan RLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)gyn-sha (author)
Herbst, AndreasLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)gyn-ahe (author)
Zaigham, MehreenLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)med-ma13 (author)
Obstetrik och gynekologi, LundSektion V (creator_code:org_t)

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In:Case Rep Womens Health: Elsevier BV27, s. e00240-2214-9112

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

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