Key result
ECMO supports safe delivery and complete maternal recovery in 2 severe COVID-19 cases.
Why the study?
Severe COVID-19 in pregnancy may require ECMO support, but maternal and neonatal outcomes in this context are not well described.
Is ECMO a feasible and safe treatment for pregnant women with severe COVID-19 ARDS?
Case Report (n=2)
No
Is ECMO a feasible and safe treatment for pregnant women with severe COVID-19 ARDS?
ECMO is a feasible treatment for pregnant women with severe COVID-19 ARDS, and delivery can be performed safely while on ECMO without vertical transmission.
May support ECMO feasibility in pregnant COVID-19 ARDS; leaves open optimal timing and generalizability.
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..
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Douglass et al. (2020) conducted a case report in ARDS secondary to COVID-19 in pregnancy (n=2). Extracorporeal membrane oxygenation (ECMO) was evaluated on Maternal and neonatal outcomes. Both pregnant women with severe COVID-19 requiring ECMO recovered with no clinical sequelae, and delivery was performed safely on ECMO with no vertical transmission to the neonates.
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