Dilemma in treating a severely ill COVID 19 pregnant patient far from term: A case report

Abstract

Background: Covid-19 presents with plethora of symptoms & signs, whereas pregnant people might be at increased risk for severe illness from COVID-19 compared to non-pregnant people probably due to changes in anatomy, endocrine, and immune factors during pregnancy. Additionally, there may be an increased risk of adverse pregnancy outcomes, such as preterm birth, intrauterine fetal demise. Case report: A 35yr old G3P2L2 with 33 weeks 1 day of gestation with prev 2 lscs with COVID-19 positive with severe respiratory distress admitted to ICU for ventilator support. She required an emergency caesarean section in view of deteriorating medical condition. 14 days postnatally, both mother & baby were discharged with no complications. Conclusion: Covid-19 in pregnancy pose a imperative aspect in its management as we do not have set guidelines on management of pregnant women & her baby in critical care setup during this pandemic. Decision making for delivery should highlight the balance of risk & benefit for maternal status & fetal status.