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.

中文翻译：

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孕妇 COVID-19 阳性患者的体外膜氧合和紧急剖腹产

介绍：

2019 年冠状病毒 (COVID-19) 感染孕妇的体外膜肺氧合 (ECMO) 治疗数据有限。在这里，我们报告了一例在 COVID-19 阳性母亲接受 ECMO 支持时进行的紧急剖宫产手术。

案例报告：

一名孕龄 26 周的 36 岁 COVID-19 阳性患者出现呼吸衰竭，需要体外膜氧合治疗。九天后胎儿窘迫要求紧急剖腹产。ECMO 治疗 5 周后，患者断奶。母亲和孩子都出院了。

讨论：

进行紧急剖腹产的决定需要主治团队经过深思熟虑。肺成熟是关键，因为在 ECMO 期间可能需要随时终止妊娠。

结论：

关于 ECMO 支持感染 COVID-19 的孕妇的数据很少。确保充分的抗凝、仔细选择插管、持续的胎儿监测、早期肺成熟和精确的分娩时间可以获得最佳结果。