Perinatology.  2023 Mar;34(1):46-52. 10.14734/PN.2023.34.1.46.

Emergency Cesarean Section in the Intensive Care Unit for a Woman with Severe Preeclampsia and Coronavirus Disease 2019: A Case Report

• Kim HM
• Kwon KT
• Seong WJ
• Cha HH
• Yu B
• Kim MJ

• KMID: 2544110
• DOI: http://doi.org/10.14734/PN.2023.34.1.46

Abstract

While pregnant women are potentially more vulnerable to respiratory infections, the clinical course of coronavirus disease 2019 (COVID-19) is worse in pregnant women than non-pregnant women of the same age. Moreover, COVID-19 is closely associated with the development of preeclampsia; both diseases can be fatal to pregnant women and fetuses in severe cases, and urgent intervention may be required. Here, we present the case of a healthy 34-year-old pregnant woman, gravida 2, para 0, transferred to a tertiary center specializing in infection a day after a confirmed diagnosis of COVID-19 due to aggravating symptoms at 31 weeks and 5 days of gestation. While under oxygen therapy, patient developed symptoms, including high blood pressure, proteinuria, elevated liver enzyme levels, and decreased platelet count. Patient was diagnosed with severe preeclampsia at 32 weeks and 4 days of gestation. In close cooperation with multidisciplinary teams, emergency cesarean section was performed in the intensive care unit (ICU) at 33 weeks and 1 day of gestation. The neonate tested negative for COVID-19 on 2 tests performed over a 48-hour period. Although quarantine was lifted, the neonate continued to receive ICU care as a preterm baby. The patient was discharged 19 days after the cesarean section, without major complications. Medical staff should be aware of the overlapping effect of the combination of COVID-19 and preeclampsia on adverse pregnancy outcomes. Close interaction between multiple departments is essential to make quick judgments and to administer the correct treatment in a timely manner. Thus, a multidisciplinary consensus is critical for achieving the best maternal and fetal outcomes.

Keyword

Cesarean section; COVID-19; Intensive care units; Pre-eclampsia; Third trimester of pregnancy