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

American Journal of Perinatology, Table of Contents

Am J Perinatol 2021; 38(01): 082-087
DOI: 10.1055/s-0040-1718694

Original Article

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

K. Marie Douglass

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles

,

Katie M. Strobel

²Division of Neonatology, Department of Pediatrics, University of California, Los Angeles

,

Michael Richley

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles

,

Thalia Mok

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles

,

Annabelle de St Maurice

³Division of Infectious Disease, Department of Pediatrics, University of California, Los Angeles

,

Viviana Fajardo

²Division of Neonatology, Department of Pediatrics, University of California, Los Angeles

,

Andrew T. Young

⁴Division of Critical Care, Department of Anesthesia, University of California, Los Angeles

,

Rashmi Rao

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles

,

Lydia Lee

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles

,

Peyman Benharash

⁵Divison of Cardiac Surgery, Department of Surgery, University of California, Los Angeles

,

Alison Chu

²Division of Neonatology, Department of Pediatrics, University of California, Los Angeles

,

Yalda Afshar

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles

› Author Affiliations

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.

Keywords

severe acute respiratory syndrome-coronavirus-2 - COVID-19 - extracorporeal membrane oxygenation - respiratory distress syndrome - pregnancy

Full Text

References

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