Maternal-Neonatal Dyad Outcomes of Maternal COVID-19 Requiring Extracorporeal Membrane Support: A Case Series

K Marie Douglass; Katie M Strobel; Michael Richley; Thalia Mok; Annabelle de St Maurice; Viviana Fajardo; Andrew T Young; Rashmi Rao; Lydia Lee; Peyman Benharash; Alison Chu; Yalda Afshar

doi:10.1055/s-0040-1718694

Maternal-Neonatal Dyad Outcomes of Maternal COVID-19 Requiring Extracorporeal Membrane Support: A Case Series

Am J Perinatol. 2021 Jan;38(1):82-87. doi: 10.1055/s-0040-1718694. Epub 2020 Oct 17.

Authors

Affiliations

¹ Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles.
² Division of Neonatology, Department of Pediatrics, University of California, Los Angeles.
³ Division of Infectious Disease, Department of Pediatrics, University of California, Los Angeles.
⁴ Division of Critical Care, Department of Anesthesia, University of California, Los Angeles.
⁵ Divison of Cardiac Surgery, Department of Surgery, University of California, Los Angeles.

Abstract

Objective: This study aimed to describe two cases of acute respiratory distress syndrome (ARDS) secondary to novel coronavirus disease 2019 (COVID-19) in pregnant women requiring extracorporeal membrane oxygenation (ECMO), and resulting in premature delivery.

Study design: The clinical course of two women hospitalized with ARDS due to COVID-19 care in our intensive care (ICU) is summarized; both participants provided consent to be included in this case series.

Results: Both women recovered with no clinical sequelae. Neonatal outcomes were within the realm of expected for prematurity with the exception of coagulopathy. There was no vertical transmission to the neonates.

Conclusion: This case series highlights that ECMO is a feasible treatment in the pregnant woman with severe COVID-19 and that delivery can be performed safely on ECMO with no additional risk to the fetus. While ECMO carries its natural risks, it should be considered a viable option during pregnancy and the postpartum period.

Key points: · COVID-19 may present with a more severe course in pregnancy.. · ECMO may be used in pregnant woman with severe COVID-19.. · Delivery can be performed on ECMO without added fetal risk..

Publication types

Case Reports

MeSH terms

Adult
COVID-19 Drug Treatment*
COVID-19* / complications
COVID-19* / diagnosis
COVID-19* / physiopathology
Cesarean Section / methods
Critical Care / methods
Extracorporeal Membrane Oxygenation* / adverse effects
Extracorporeal Membrane Oxygenation* / methods
Female
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical / prevention & control
Obesity / diagnosis
Pregnancy
Pregnancy Complications, Infectious* / diagnosis
Pregnancy Complications, Infectious* / physiopathology
Pregnancy Complications, Infectious* / therapy
Pregnancy Outcome
Respiration, Artificial / methods*
Respiratory Distress Syndrome* / physiopathology
Respiratory Distress Syndrome* / therapy
Respiratory Distress Syndrome* / virology
Risk Adjustment / methods
SARS-CoV-2 / isolation & purification*
Treatment Outcome