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Published on: August 15, 2022
Extra-corporeal membrane oxygenation and emergency C-section for a pregnant COVID-19 positive patient
Alejandro Quintero1, Eric E Vinck1, Luz E Pérez2
1Department of Cardiovascular Surgery & Mobile ECMO, Pontifical Bolivarian University, Cardio VID Clinic, Medellín, Antioquia, Colombia.
Introduction:
Data on extra-corporeal membrane oxygenation (ECMO) therapy for pregnant patients with Coronavirus 2019 (COVID-19) infection are limited. Here we report a case of an emergency cesarean section performed while the COVID-19 positive mother was on ECMO support.
Case Report:
A 36-year-old COVID-19 positive patient at 26 weeks gestational age presented with respiratory failure requiring extra-corporeal membrane oxygenation therapy. Nine days later fetal distress demanded an emergency C-section. After 5 weeks on ECMO, the patient was weaned off. Both mother and child were discharged.
Discussion:
The decision to perform an urgent C-section is one that requires meticulous thought from the attending team. Pulmonary maturation is key as pregnancy may need to be terminated at any time during ECMO.
Conclusion:
Data on ECMO support for pregnant patients with COVID-19 infection are scarce. Best results can be achieved ensuring adequate anticoagulation, meticulous choice of cannulas, continued fetal monitoring, early lung maturation, and precision timing of delivery.
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