Timing of delivery with coronavirus disease 2019 pneumonia requiring intensive care unit admission

Carl H Rose1, Michelle A Wyatt1, Kavita Narang1

  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN (Drs Rose, Wyatt, Narang, Lorenz, and Szymanski); Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics and Division of Surgical Critical Care, Department of Surgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD (Dr Vaught).

Approximately 4% of pregnant patients with coronavirus disease 2019 require intensive care unit admission. Given the practical implications of advanced ventilatory and circulatory support techniques, urgent or emergent delivery for nonreassuring fetal status frequently presents a logistical impossibility. This article proposes a protocol for obstetrical management of patients in these situations, emphasizing coordinated preparation among obstetrical, anesthesiology, and intensivist teams for planned preterm delivery at gestational ages when neonatal outcomes are likely to be favorable.

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