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Objective: This study examined the clinical consequences of pregnancy coexisting with severe acute respiratory syndrome coronavirus 2 in the intensive care unit (ICU). Materials and Methods: The study was designed as a retrospective observational study. After the ethical approval of the local ethics committee, the study was conducted for a period when the number of young coronavirus disease-2019 (COVID-19) cases increased in our country. The patients enrolled in the study were pregnant/puerperal patients followed up in our third-level ICU. Results: The mean age of 35 pregnant women included in the study was 29.57±4.36 years. Twenty-one of the births (80.8%) were preterm births. Twelve (34.3%) patients received invasive mechanical ventilation (IMV), and 5 (41.7%) of these patients were deceased. Twenty-six (74.3%) underwent a cesarean section (C/S). There were 5 (14.3%) patients who needed extracorporeal membrane oxygenation and 3 (8.5%) patients who needed continuous renal replacement therapy. The 28-day neonatal mortality rate for 26 births was 3.8%. The maternal mortality rate in the ICU was 14.3%. Conclusion: The preterm birth rate was high in our pregnant patients followed up in the ICU with a diagnosis of COVID-19. Because of clinical and radiological progression in pregnant women, it is difficult to indicate any gestational week in which maternal outcomes are better to undergo C/S. IMV mortality is not higher than in non-pregnant patients, so endotracheal intubation should not be avoided in appropriate patients, whether pregnancy continues or not. The absence of fully vaccinated patients in the study group revealed the protective effect of vaccination during pregnancy. [ABSTRACT FROM AUTHOR]

The maternal and fetal mortality rate in unstable pulmonary embolisms accompanied by obstructive cardiac shock is approximately 30%. An intervention aimed at the pulmonary clot is essential under these conditions. There are various ways of removing this clot from the pulmonary arteries, including thrombolytic administration, percutaneous catheter-based thrombectomy, and direct surgical clot removal. These procedures all have advantages and disadvantages. Increasing use is being made of extracorporeal membrane oxygenation (ECMO) as a means of reducing these risks to a minimum. There are studies recommending ECMO together with thrombolysis or surgical thrombectomy. However, which study is superior to another is unclear. The purpose of the present study was, therefore, to assess the benefits and risks of ECMO use in pregnant patients with pulmonary embolism and to endeavor to produce a new algorithm. [ABSTRACT FROM AUTHOR]

Objective: The new coronavirus disease, in which hundreds of thousands of people are infected in the world, appears in tables ranging from asymptomatic course to severe acute respiratory distress syndrome. Extracorporeal membrane oxygenation (ECMO) is one of the salvage treatments applied in intubated patients due to high mortality. We aimed to describe our experience in a COVID-19 infected pregnant woman with ECMO theraphy in our clinic. Case: A 37-year-old patient who was 34 weeks pregnant presented with a fever of 39 °C for 3 days, and a cough. Because of the appearance of bilateral ground glass on CT, viral pneumonia. She was admitted into our intensive care unit, and high dose of vitamin C, and tocilizumab (a humanized monoclonal antibody against the interleukin-6 receptor) were added to the treatment. The patient had increased respiratory difficulty (SpO2: %83) and was taken under the support of MV. Venovenous ECMO treatment was planned on the third day of intubation The results of a laboratory examination were leukocyte: 14.03 K/uL; neutrophiltolymphocyte ratio: 19.35; C-reactive protein: 244.8 mg/L; ferritin: 140.7 µg/L; procalcitonin: 14.7 ng/mL; D-dimer: 13.300 ng/mL and fibrinogen: 790 mg/Dl. The first polymerase chain reaction test was evaluated as SARSCoV-2 positive favipiravir 200 mg PO 2x3, piperacilin-tazobactam 3x4,5 gr IV and enoxaparin 6000 IU SC 2x1 were initiated. On the seventh day of ECMO, the patient developed sudden hypotension, metabolic acidosis, and P/F rate quickly dropped below 100. The patient died despite all the necessary interventions. Conclusion: ECMO indications are respiratory insufficiency, P/F ratio below 100, MV time of less than 7 days, age below 65 years. We could not achieve a successful result, we believe that new experiences. [ABSTRACT FROM AUTHOR]