Despite the overwhelming number of coronavirus disease 2019 (COVID-19) cases worldwide, data regarding the optimal clinical guidance in pregnant patients is not uniform or well established. As a result, clinical decisions to optimize maternal and fetal benefit, particularly in patients with critical COVID-19 in the early preterm period, continue to be a challenge for obstetricians. There is often uncertainty in clinical judgment about fetal monitoring, timing of delivery, and mode of delivery because of the challenge in balancing maternal and fetal interests in reducing morbidity and mortality. The obstetrician and critical care team should empower pregnant patients or their surrogate decision maker to make informed decisions in response to the team’s clinical evaluation. A clinically grounded ethical framework, based on the concepts of the moral management of medical uncertainty, beneficence-based obligations, and preventive ethics, should guide the decision-making process.

中文翻译：

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2019 年冠状病毒病 (COVID-19) 危重妊娠患者管理中的伦理挑战

尽管全球 2019 年冠状病毒病 (COVID-19) 病例数量庞大，但有关孕妇最佳临床指导的数据并不统一或不完善。因此，优化母婴获益的临床决策，尤其是在早产早期的危重 COVID-19 患者中，仍然是产科医生面临的挑战。由于在降低发病率和死亡率方面平衡母婴利益的挑战，关于胎儿监护、分娩时间和分娩方式的临床判断通常存在不确定性。产科医生和重症监护团队应授权怀孕患者或其代理人决策者根据团队的临床评估做出明智的决定。一个以临床为基础的伦理框架，