A Case Report on the Unique Challenges of COVID-19 Infection During Perioperative Anesthesia Care for a Laboring COVID-19-Infected Mother in a Low-Resource Area

Abstract

BACKGROUND: Recently, the rate of cesarean sections has increased, addressing the concern of anesthesia for cesarean sections in a similar manner. Physiological changes during pregnancy, such as increased cardiac output, heart rate, and oxygen consumption, decreased lung compliance and capacity, immune modulation (an altered response of the cell-mediated immunity), and increased risk of thromboembolic disease reduce maternal compensation during stress and certain pathological conditions like infections. Importantly, the provision of anesthesia for a pregnant mother is perceived as a challenging situation because of the attendant physiological, anatomical, and pharmacological changes in pregnancy. This culminates in the modification and dosage adjustment for certain medications, especially sedative-hypnotics and delivery, as well as the management of anesthetic techniques, to optimize and ensure maternal organ function and fetal well-being. Certain perioperative factors, such as COVID-19 infection, comorbid disease, and obstetric complications, increase the risk of maternal morbidity and mortality with a subsequent fetal compromise during the perioperative state, besides the aforementioned anesthetic challenges. Moreover, COVID-19 infection increases the perils of complicating pregnancy and pregnancy outcomes, including maternal artificial ventilation and intensive care admission, preterm labor, fetal distress, neonatal intensive care admission, and fetal and maternal deaths. CONCLUSION: Preventive strategies toward the spread of the COVID-19 infection, vaccines, and the proper use of personnel protective equipment by healthcare providers reduce the spread and severity of the COVID-19 infection and improve obstetric and pregnancy outcomes.