Case of the Month #23 - obstetrics & SARS-CoV-2

Published 01/02/2022

What is the risk profile of a pregnant woman with SARS-CoV-2?

The ICNARC report of January 2021 describes 12% of critically ill women aged between 16-49 years with COVID-19 as being pregnant or recently pregnant (1). This is a significant increase since the first wave, as reported in COVID-19 ICNARC April 2020. Whether this is just due to overall increased community prevalence or a factor of the new variant is unknown at present.

While this is a population we usually think of as being physiologically robust, we know that pregnant women were at especially high risk of developing complications during the relatively recent H1N1 pandemic (2). And pregnancy does present a challenge to the critical care community in this regard. An already impaired respiratory capacity, frequent need for expediting delivery and/or operative intervention, the necessity of MDT management of both mother and baby, logistical barriers to appropriate settings of clinical care and inclusion in therapeutic trials are but a few.