妊娠中期に重症化した新型コロナウイルス感染症に対して集学的加療を行い母子ともに救命した1例(A case of a pregnant woman with severe COVID–19 who was treated by multidisciplinary therapy)

ABSTRACT We report a case of a patient with coronavirus disease (COVID–19) in the second trimester of pregnancy who was started on venovenous extracorporeal membrane oxygenation (VV–ECMO) immediately after a cesarean section with ventilation and prone positioning, resulting in a good outcome for both the mother and the child. The patient, a woman in her 30s was transferred to our hospital due to worsening respiratory status at 28 weeks and 0 days of gestation, 8 days after the onset of COVID–19. On the second day, she was started on mechanical ventilation. Although the period of pregnancy was prolonged by prone ventilation, because the PaO2/FiO2 ratio (P/F) decreased to 76, we performed a cesarean section on the eighth day. She was started on VV–ECMO on the ninth day. Thereafter, her respiratory condition gradually improved, and she was weaned from VV–ECMO on the twenty–second day. Later, she was extubated on the twenty–fourth day and transferred from the intensive care unit to the general ward on the thirtieth day. In cases of COVID–19 that become severe in the second trimester of pregnancy, multidisciplinary treatment is necessary, taking into consideration the number of weeks of pregnancy.