Year 2024,
Volume: 1 Issue: 1, 20 - 26, 31.01.2024
Azime Bulut
,
Fatma Alkan Bayburt
,
Gizem Zaim
,
Dilek Yeniay
,
İlknur Şenel
,
Gökhan Ordu
References
- 1) Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395:497–506.
- 2) Lokken EM, Huebner EM, Taylor GG et al. Disease severity, pregnancy outcomes, and maternal deaths among pregnant patients with severe acute respiratory syndrome coronavirus 2 infection in Washington State. Am J Obstet Gynecol. 2021;225(1):77. e1-77. e14.
- 3) DeBolt CA, Bianco A, Limaye MA et al. Pregnant women with severe or critical coronavirus disease 2019 have increased composite morbidity compared with nonpregnant matched controls. Am J Obstet Gynecol. 2021;224(5):510.e1-510.e12.
- 4) SoHee Kim, Choi Y, Lee Det al. Impact of COVID-19 on pregnant women in South Korea: Focusing on prevalence, severity, and clinical outcomes. J Infect Public Health. 2022 15(2):270-276.
- 5) Troiano H, Richter A, King C. Acute Respiratory Failure and Mechanical Ventilation in Women With COVID-19 During Pregnancy: Best Clinical Practices. J Perinat Neonatal Nurs. 2022;36(1):27-36.
- 6) Zambrano LD, Ellington S, Strid P, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(44):1641-1647.
- 7) Lokken EM, Taylor GG, Huebner EM et al. Higher severe acute respiratory syndrome coronavirus 2 infection rate in pregnant patients. Am J Obstet Gynecol. 2021;225(1): 75.e1-75e16.
- 8) Wastnedge EAN, Reynolds RM, van Boeckel SR, et al. Pregnancy and COVID-19. Physiol Rev. 2021; 101(1):303–318.
- 9) Goodnight WH, Soper DE. Pneumonia in pregnancy. Crit Care Med. 2005;33(10 Suppl):S390-S397.
- 10) Ellington S, Strid P, Tong VT, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):769-775.
- 11) Oxford-Horrey C, Savage M, Prabhu M et al. Putting It All Together: Clinical Considerations in the Care of Critically Ill Obstetric Patients with COVID-19. Am J Perinatol. 2020; 37(10):1044-1051.
- 12) Huang S, Zhao S, Luo H, et al. The role of extracorporeal membrane oxygenation in critically ill patients with COVID-19: a narrative review. BMC Pulm Med. 2021;21(1):116.
- 13) Kadir RA, Kobayashi T, Iba T, et al. COVID-19 coagulopathy in pregnancy: Critical review, preliminary recommendations, and ISTH registry-Communication from the ISTH SSC for Women's Health. J Thromb Haemost. 2020;18(11):3086-3098.
- 14) D'Souza R, Malhamé I, Teshler L, Acharya G, Hunt BJ, McLintock C. A critical review of the pathophysiology of thrombotic complications and clinical practice recommendations for thromboprophylaxis in pregnant patients with COVID-19. Acta Obstet Gynecol Scand. 2020;99(9):1110-1120.
- 15) The Royal College of Obstetricians and Gynaecologists. Coronavirus (COVID-19) vaccination in pregnancy. Information for healthcare professionals Version 16. Updated December 15, 2022. Accessed April 9, 2023. https://www.rcog.org.uk/guidance/coronavirus-covid-19-pregnancy-and-women-s-health/coronavirus-covid-19-infection-in-pregnancy/
- 16) Blakeway H, Prasad S, Kalafat E et al. COVID-19 vaccination during pregnancy: coverage and safety. Am J Obstet Gynecol. 2022;226(2): 236.e1-236.e14.
- 17) Pham A, Aronoff DM, Thompson JL. Maternal COVID-19, vaccination safety in pregnancy, and evidence of protective immunity. J Allergy Clin Immunol. 2021;148(3):728-731.
- 18) Tapias LF, Lanuti M, Wright CD et al. COVID-19-related Post-intubation Tracheal Stenosis Early Experience With Surgical Treatment. Ann Surg. 2022; 275(1): e271–e273.
Maternofetal outcome and six months follow-up of pregnant patients with acute respiratory distress syndrome due to Covid-19 in intensive care
Year 2024,
Volume: 1 Issue: 1, 20 - 26, 31.01.2024
Azime Bulut
,
Fatma Alkan Bayburt
,
Gizem Zaim
,
Dilek Yeniay
,
İlknur Şenel
,
Gökhan Ordu
Abstract
Objective: In this study, it was aimed to evaluate pregnant patients followed in the intensive care unit (ICU) with severe acute respiratory distress syndrome due to COVID-19.
Material and method: In this study, all pregnant patients infected with COVID-19 who were admitted to the ICU with the diagnosis of acute respiratory distress syndrome (ARDS) were evaluated retrospectively. Demographic, laboratory and clinical findings and follow-up of the mother and newborn at least 6 months after discharge were recorded.
Results: A total of 17 patients were included in this study. Three of the patients died in the ICU, 13 patients were discharged, 1 patient is still being followed up in the palliative care unit. 14 of 17 patients required mechanical ventilation and 11 patients were extubated. All patients had not been vaccinated. We detected tracheal stenosis in four of the eleven patients who were intubated and survived.
Conclusion: While managing pregnant patients with respiratory failure, making decisions about delivery timing remains the most controversial. Based on our experience, we can say that if the week of gestation is compatible with life, the decision to deliver should be taken before severe progression of the mother’s respiratory distress. Tracheal stenosis formation caused by intubation should be suspected even in short intubation periods in pregnant patients. In this, the addition of factors such as giving prone position, not following appropriate cuff pressure to physiological changes in pregnancy is involved.
References
- 1) Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395:497–506.
- 2) Lokken EM, Huebner EM, Taylor GG et al. Disease severity, pregnancy outcomes, and maternal deaths among pregnant patients with severe acute respiratory syndrome coronavirus 2 infection in Washington State. Am J Obstet Gynecol. 2021;225(1):77. e1-77. e14.
- 3) DeBolt CA, Bianco A, Limaye MA et al. Pregnant women with severe or critical coronavirus disease 2019 have increased composite morbidity compared with nonpregnant matched controls. Am J Obstet Gynecol. 2021;224(5):510.e1-510.e12.
- 4) SoHee Kim, Choi Y, Lee Det al. Impact of COVID-19 on pregnant women in South Korea: Focusing on prevalence, severity, and clinical outcomes. J Infect Public Health. 2022 15(2):270-276.
- 5) Troiano H, Richter A, King C. Acute Respiratory Failure and Mechanical Ventilation in Women With COVID-19 During Pregnancy: Best Clinical Practices. J Perinat Neonatal Nurs. 2022;36(1):27-36.
- 6) Zambrano LD, Ellington S, Strid P, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(44):1641-1647.
- 7) Lokken EM, Taylor GG, Huebner EM et al. Higher severe acute respiratory syndrome coronavirus 2 infection rate in pregnant patients. Am J Obstet Gynecol. 2021;225(1): 75.e1-75e16.
- 8) Wastnedge EAN, Reynolds RM, van Boeckel SR, et al. Pregnancy and COVID-19. Physiol Rev. 2021; 101(1):303–318.
- 9) Goodnight WH, Soper DE. Pneumonia in pregnancy. Crit Care Med. 2005;33(10 Suppl):S390-S397.
- 10) Ellington S, Strid P, Tong VT, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):769-775.
- 11) Oxford-Horrey C, Savage M, Prabhu M et al. Putting It All Together: Clinical Considerations in the Care of Critically Ill Obstetric Patients with COVID-19. Am J Perinatol. 2020; 37(10):1044-1051.
- 12) Huang S, Zhao S, Luo H, et al. The role of extracorporeal membrane oxygenation in critically ill patients with COVID-19: a narrative review. BMC Pulm Med. 2021;21(1):116.
- 13) Kadir RA, Kobayashi T, Iba T, et al. COVID-19 coagulopathy in pregnancy: Critical review, preliminary recommendations, and ISTH registry-Communication from the ISTH SSC for Women's Health. J Thromb Haemost. 2020;18(11):3086-3098.
- 14) D'Souza R, Malhamé I, Teshler L, Acharya G, Hunt BJ, McLintock C. A critical review of the pathophysiology of thrombotic complications and clinical practice recommendations for thromboprophylaxis in pregnant patients with COVID-19. Acta Obstet Gynecol Scand. 2020;99(9):1110-1120.
- 15) The Royal College of Obstetricians and Gynaecologists. Coronavirus (COVID-19) vaccination in pregnancy. Information for healthcare professionals Version 16. Updated December 15, 2022. Accessed April 9, 2023. https://www.rcog.org.uk/guidance/coronavirus-covid-19-pregnancy-and-women-s-health/coronavirus-covid-19-infection-in-pregnancy/
- 16) Blakeway H, Prasad S, Kalafat E et al. COVID-19 vaccination during pregnancy: coverage and safety. Am J Obstet Gynecol. 2022;226(2): 236.e1-236.e14.
- 17) Pham A, Aronoff DM, Thompson JL. Maternal COVID-19, vaccination safety in pregnancy, and evidence of protective immunity. J Allergy Clin Immunol. 2021;148(3):728-731.
- 18) Tapias LF, Lanuti M, Wright CD et al. COVID-19-related Post-intubation Tracheal Stenosis Early Experience With Surgical Treatment. Ann Surg. 2022; 275(1): e271–e273.