The 31-year-old mother had an emergency C-section before being placed on ECMO, a “last resort” procedure that allows the heart and lungs to heal by restoring their function.

In a case study cited at Euroanaesthesia, doctors in Croatia reveal a pregnant COVID-19 patient’s 22-day battle for survival.

The 31-year-old mother, who had not been vaccinated against Covid, had an emergency C-section before being placed on ECMO (extracorporeal membrane oxygenation), a “last resort” procedure that substitutes the heart and lungs’ function, allowing them to recuperate.

The woman started to feel sick with COVID-19 on October 16, 2021, and four days later, on October 20, she tested positive. On October 26, she presented with symptoms including shortness of breath, a cough, and weakness, which led to her admission to University Hospital Split in Croatia.

The woman, who was 33 weeks pregnant at the time of admission, had no serious medical problems.

Her symptoms were minor at first, but they worsened quickly, causing concern. Despite being given supplemental oxygen, her breathing became worse a few hours after admission.

The woman was intubated and a C-section was performed by an interdisciplinary team directed by Assoc. Prof. Sanda Stojanovic Stipic, which included ICU and maternal-fetal medicine experts.

“The patient’s condition was deteriorating quickly,” points out Dr. Filip Peris, an anaesthesiologist and member of the team caring for the woman at University Hospital Split’s Department of Anaesthesiology & Intensive Care.

“We had a short timeframe before baby’s health would do the same, so we put a team together and discussed the best thing for both mother and child, to try to save their both lives.

“Given that the gestational age of the child was quite advanced, and the mother’s health was deteriorating quickly, we decided to do a C-section.

“Pregnancy is a stressful time for the body and delivering the baby would give the mother’s lungs time to heal on their own.”

The newborn, a healthy boy weighing 2,380g (5lb 4oz), did not require any extra medical attention.

The woman was taken to the hospital’s Covid ICU after the C-section and placed on a ventilator. Despite this, she had an 85 percent lung function ratio (P/F). Ratios below 100 are considered to be severe ARDS. ARDS is a condition in which the lungs are so badly damaged that the air sacs, called alveoli, start to fill with fluid.

Her lung function ratio continued to decline, and she was placed on ECMO.

“The mother’s condition was life-threatening and mechanical ventilation was not enough to heal her lungs,” adds Dr. Peris.

“ECMO was her last chance. In our hospital, we use ECMO 3-5 times in a year.

“Her lung function gradually improved and she was weaned off ECMO after nine days. On 17 November, and following a 22-long-day battle for survival, mother and child were discharged home.”

After receiving intense treatment in the hospital and at home, the woman has made a full recovery. Her son is in good health as well.

“Every step of her battle was closely monitored by our wonderful team of anaesthesiologists and our ICU nurses,” adds Dr. Peris. 

Pregnancy, according to the woman’s doctors, is not a contraindication for ECMO.

“Recent studies show us that survival rates after ECMO use in pregnancy are high, for both mother and child,” they write.

“The risks and benefits for both the mother and foetus must be weighed against each other,” says Dr. Peris. “In this situation, the foetus’s advanced gestational age was balanced against the mother’s rapidly deteriorating clinical condition .”

“Timing is everything in medicine. The right timing saves lives.”

The woman had not received a COVID-19 vaccine. “Vaccination is tremendously important – it saves lives,” says Dr. Peris.

“Studies show there are no safety concerns for babies born to women who were vaccinated against COVID-19 during pregnancy.

“I urge you to have your vaccine as soon as possible.”

Image Credit: Getty

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