Extracorporeal membrane oxygenation use in a 26-week pregnant female with a severe COVID-19 infection: Case report

Background: The SARS-COV-19 (COVID-19) pandemic has been an unprecedented global health crisis that has had far reaching implications and has exposed various susceptible patient populations including pregnant women. The effect of COVID-19 on pregnant women is an area of current research, with many studies focusing on maternal and fetal outcomes and maternal-fetal transmission of the virus. Current research suggests that COVID-19 presents similarly in both non-pregnant and pregnant women. Although COVID-19 is rarely vertically transmitted, it is currently unclear whether or not COVID-19 has an effect on the incidence of IUFD in pregnant patients. Case Description: Here, we report the case of a 23-year-old female approximately 26 weeks pregnant, recently diagnosed with COVID-19. The patient required intubation during evaluation in the emergency department (ED) and ultimately was placed on extracorporeal membrane oxygenation (ECMO) while in the intensive care unit (ICU). During the ICU stay intrauterine fetal demise (IUFD) was diagnosed and a spontaneous en caul vaginal delivery occurred. Conclusions: Currently, there is limited data available regarding the effect, or complications, of COVID-19 on the three trimesters of pregnancy. There is also limited data on the use of ECMO in pregnant patients with a COVID-19 infection. The case reported here is further evidence of the necessity of further research into the effects of COVID-19 on pregnant patients and the utilization of ECMO in these cases.