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    ΠΕΙΡΑΜΑΤΙΚΕΣ – ΚΛΙΝΙΚΕΣ ΜΕΛΕΤΕΣ
ΥΠΌΨΗΦΙΕΣ ΕΡΓΑΣΙΕΣ ΓΙΑ ΒΡΑΒΕΥΣΗ
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         A CASE SERIES ON CRITICALLY ILL PREGNANT ADMITTED TO ICU IN ALEXANDRA HOSPITAL, ATHENS, GREECE
Giolanda Varvarousi1, Maria Papa1, Athanasia Saiti1, Vasiliki Skandalou1, Konstantinos Tasias2, Stamatakis Emmanouil1, Dimitrios Valsamidis1
1Department of Anaesthesiology, Obstetric Department, Alexandra Hospital, Athens, Greece 2 Department of Obstetrics and Gynecology, Alexandra Hospital, Athens, Greece
    Aim: Pregnant women with COVID-19 may be at high risk of developing moderate or severe acute respiratory distress syndrome (ARDS). However, data of intensive care unit (ICU) admission and management of pregnant women infected with SARS-CoV-2 are scarce. We present a Greek single-center observational case study of 5 confirmed COVID-19 pregnant women admitted to ICU from January 2021 to May 2021.
Case series: All five women were admitted to ICU with moderate or severe ARDS related to Covid 19 infection. Based on a concern for further respiratory decompensation, the decision was made to proceed with intubation and urgent delivery in three pregnant women of 37,6 wks, 33wks and 27wks respectively. The parturient with the pregnancy of 37 weeks and 6 days developed cardiomyopathy with echocardiographic signs of globally reduced left ventricular systolic function. One woman was intubated 2 days after caesarean section due to progressive hypoxemia and one was intubated due to hypoxemic respiratory failure and haematoma of rectus abdominis muscle 4 days after caesarean section. Four women recovered from ARDS in the ICU. The parturient with pregnancy of 27 wk died due to septic shock.
Conclusion: These five cases of critically ill pregnant women with confirmed COVID-19 ARDS suggest that early admission and management in the ICU may decrease maternal mortality and morbidity. Admission to ICU in order to maintain oxygenation and hemodynamic stability remain the mainstay goals in treating critically ill COVID-19 pregnant women. Important considerations include early detection of ARDS due to Covid 19 and individualized decisions regarding timing of caesarean section.
REFERENCES:
1. Ayumu Ito, Eijiro Hayata, Masahiko Nakata, et al. Rapid recovery achieved by intensive therapy after preterm cesarean section for worsening COVID-19- induced acute respiratory failure: A case report and literature review Case Rep Womens Health. 2021;30:e00315
2. Sushil Chawla 1, M Nakra 2, S Mohan, et al. Rapid recovery achieved by intensive therapy after preterm cesarean section for worsening COVID-19-induced acute respiratory failure: A case report and literature review Case Rep Womens Health. 2021;30:e00315
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