Prone Positioning for Pregnant Women With Hypoxemia Due to Coronavirus Disease 2019 (COVID-19)

Obstetrics and Gynecology
Mary Catherine TolcherJoseph L Nates

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has prompted expanded use of prone positioning for refractory hypoxemia. Clinical trials have demonstrated beneficial effects of early prone positioning for acute respiratory distress syndrome (ARDS), including decreased mortality. However, pregnant women were excluded from these trials. To address the need for low-cost, low-harm interventions in the face of a widespread viral syndrome wherein hypoxemia predominates, we developed an algorithm for prone positioning of both intubated and nonintubated pregnant women. This algorithm may be appropriate for a wide spectrum of hypoxemia severity among pregnant women. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is responsible for the clinical manifestations of COVID-19. This syndrome can manifest as severe pneumonia complicated by hypoxemia and ARDS. Given the current global COVID-19 pandemic, with a large number of ARDS cases, there is renewed interest in the use of prone positioning to improve oxygenation in moderate or severe hypoxemia. Among the populations who can benefit from prone positioning are pregnant women experiencing severe respiratory distress, as long as the physiologic changes and risks of preg...Continue Reading

References

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Citations

Oct 30, 2020·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Joshua P VogelUNKNOWN National COVID-19 Clinical Evidence Taskforce
Dec 29, 2020·Clinical Case Reports·Massimo DonzelliAndrea Cortegiani
Feb 9, 2021·Frontiers in Medicine·Victoria TeamCarolina D Weller
Mar 8, 2021·Fertility and Sterility·Naima T JosephDenise J Jamieson
Mar 31, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Carson WelkerHarish Ramakrishna
Aug 18, 2021·Current Opinion in Obstetrics & Gynecology·Ayub KhanSanjay Wijayatilake
Nov 7, 2021·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Ana Carolina Rodarti PitanguiCristine Homsi Jorge Ferreira
Dec 18, 2021·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Liviu CojocaruSifa Turan
Jan 20, 2022·Clinical Obstetrics and Gynecology·Ruth LandauLaurence E Ring
Jan 29, 2022·The Journal of Perinatal & Neonatal Nursing·Nan H TroianoCecilia King
Feb 6, 2022·Anesthesia and Analgesia·Michael J WongBhavani Shankar Kodali

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