{"title":"与 COVID-19 相关的妊娠期严重急性呼吸窘迫综合征(ARDS):及时分娩可能挽救生命--病例报告和文献综述","authors":"Mohini Sachdeva, Kallol Kumar Roy, Rinchen Zangmo, Nilanchali Singh, Juhi Bharti","doi":"10.1007/s42399-024-01710-5","DOIUrl":null,"url":null,"abstract":"<p>To assess if preterm termination of pregnancy improves maternal outcome in COVID-19 ARDS. A 35-year-old, woman at 36 weeks period of gestation with severe COVID-19-related ARDS, whose rapid deterioration despite starting steroids, antibiotics, low molecular weight heparin, and optimizing ventilatory support, led us to intervene with a preterm emergency cesarean section. The most important factor in consideration was the limitation of maternal respiratory management due to pregnancy and superimposed maternal metabolic acidosis with the risk of fetal acidosis. The rationale of delivery was to improve respiratory mechanics and decrease maternal oxygen requirement. Some studies have discussed the importance of preterm termination of pregnancy with severe COVID-19 ARDS and investigated its impact on feto-maternal outcomes. This aspect is important as ethical and physiologic considerations in pregnancy, obviate the use of a single protocol for all pregnant women. Timely termination of pregnancy may improve maternal outcome in severe COVID-19 ARDS.</p>","PeriodicalId":21944,"journal":{"name":"SN Comprehensive Clinical Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Severe COVID-19-Related Acute Respiratory Distress Syndrome (ARDS) in Pregnancy: Prompt Delivery May Be Life-Saving—A Case Report and Review of Literature\",\"authors\":\"Mohini Sachdeva, Kallol Kumar Roy, Rinchen Zangmo, Nilanchali Singh, Juhi Bharti\",\"doi\":\"10.1007/s42399-024-01710-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>To assess if preterm termination of pregnancy improves maternal outcome in COVID-19 ARDS. A 35-year-old, woman at 36 weeks period of gestation with severe COVID-19-related ARDS, whose rapid deterioration despite starting steroids, antibiotics, low molecular weight heparin, and optimizing ventilatory support, led us to intervene with a preterm emergency cesarean section. The most important factor in consideration was the limitation of maternal respiratory management due to pregnancy and superimposed maternal metabolic acidosis with the risk of fetal acidosis. The rationale of delivery was to improve respiratory mechanics and decrease maternal oxygen requirement. Some studies have discussed the importance of preterm termination of pregnancy with severe COVID-19 ARDS and investigated its impact on feto-maternal outcomes. This aspect is important as ethical and physiologic considerations in pregnancy, obviate the use of a single protocol for all pregnant women. Timely termination of pregnancy may improve maternal outcome in severe COVID-19 ARDS.</p>\",\"PeriodicalId\":21944,\"journal\":{\"name\":\"SN Comprehensive Clinical Medicine\",\"volume\":\"1 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"SN Comprehensive Clinical Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s42399-024-01710-5\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"SN Comprehensive Clinical Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s42399-024-01710-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Severe COVID-19-Related Acute Respiratory Distress Syndrome (ARDS) in Pregnancy: Prompt Delivery May Be Life-Saving—A Case Report and Review of Literature
To assess if preterm termination of pregnancy improves maternal outcome in COVID-19 ARDS. A 35-year-old, woman at 36 weeks period of gestation with severe COVID-19-related ARDS, whose rapid deterioration despite starting steroids, antibiotics, low molecular weight heparin, and optimizing ventilatory support, led us to intervene with a preterm emergency cesarean section. The most important factor in consideration was the limitation of maternal respiratory management due to pregnancy and superimposed maternal metabolic acidosis with the risk of fetal acidosis. The rationale of delivery was to improve respiratory mechanics and decrease maternal oxygen requirement. Some studies have discussed the importance of preterm termination of pregnancy with severe COVID-19 ARDS and investigated its impact on feto-maternal outcomes. This aspect is important as ethical and physiologic considerations in pregnancy, obviate the use of a single protocol for all pregnant women. Timely termination of pregnancy may improve maternal outcome in severe COVID-19 ARDS.