Prone Ventilation in a 27 Week Pregnant Woman with COVID-19 Severe ARDS
1Department of Anesthesia and Intensive Care, Azienda Ospedaliera Santa Croce e Carle, Via Michele Coppino 26, 12100, Cuneo, Italy
2Department of Obstetrics and Gynecology, Azienda Ospedaliera Santa Croce e Carle, Via Michele Coppino 26, 12100, Cuneo, Italy
DOI: 10.22514/sv.2020.16.0028 Vol.16,Issue 1,June 2020 pp.199-202
Published: 30 June 2020
Pregnant women are more sensitive to respiratory pathogens due to the physiological changes related to pregnancy with an increase in morbidity and mortality. Pregnancy and childbirth do not seem to aggravate the course of symptoms of COVID-19 pneumonia. However, reports on optimal management of severe COVID-19-related ARDS during pregnancy are still lacking. To our knowledge only two case reports describe prone ventilation in pregnant women with severe ARDS, no one related to COVID-19. We report the case of a COVID-19 related severe ARDS in a 48-year-old woman in the last trimester of pregnancy. The patient required intensive care hospitalization for 20 days and invasive mechanical ventilation for 15 days. Pronation maneuver during mechanical ventilation relieved hypoxia and prevented mother and fetus damages, thus avoiding an urgent cesarean section and a premature birth. The patient was successfully discharged from the hospital without maternal and fetal sequelae. In our experience prone ventilation can be safely used to improve respiratory gas exchanges in the last trimester of pregnancy in case of severe ARDS.
COVID-19, Respiratory distress syndrome, Adult, Pronation, Pregnancy, Respiration, Artificial
Luigi Barile,Martina Cerrano,Alessandro Locatelli,Andrea Puppo,Anna F. Signorile,Nicoletta Barzaghi. Prone Ventilation in a 27 Week Pregnant Woman with COVID-19 Severe ARDS. Signa Vitae. 2020. 16(1);199-202.
 Mehta N, Chen K, Hardy E, et al. Respiratory disease in pregnancy. Best Practice & Research Clinical Obstetrics and Gynaecology. 2015;29:598-611.
 Bhatia PK, Biyani G, Mohammed S, et al. Acute respiratory failure and mechanical ventilation in pregnant patient: A narrative review of literature. J Anaesthesiol Clin Pharmacol. 2016;32:431-439.
 Liu H, Wanga LL, Zhaoa SJ, et al. Why are pregnant women susceptible to COVID-19? An immunological viewpoint. J Reprod Immunol. 2020;139:103122.
 Liu D, Li L, Wu X, et al. Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. AJR Am J Roentgenol. 2020;18:1-6.
 Di Mascio D, Khalil A, Saccone G, et al. Outcome of Coronavirus spectrum infections (SARS, MERS, COVID 1 -19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2020;2:100107.
 Pelosi P, Brazzi L, Gattinoni L. Prone position in acute respiratory distress syndrome. Eur Respir J. 2002;20:1017-28.
 Pelosi P, Croci M, Calappi E, et al. Prone positioning improves pulmonary function in obese patients during general anesthesia. Anesth Analg. 1996;83:578-83.
 Oliveira C, Lopes MAB, Rodrigues AS, et al. Influence of the prone position on a stretcher for pregnant women on maternal and fetal hemodynamic parameters and comfort in pregnancy. Clinics (Sao Paulo). 2017;72:325-332.
 Kenn S, Weber-Carstens S, Weizsaecker K, et al. Prone positioning for ARDS following blunt chest trauma in late pregnancy. Int J Obstet Anesth. 2009;18:268-71.
 Samanta S, Samanta S, Wig J, et al. How safe is the prone position in acute respiratory distress syndrome at late pregnancy? Am J Emerg Med. 2014;32:687.e1-3.
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