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

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 w...

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Bibliographic Details
Published in:	Obstetrics and gynecology (New York. 1953) Vol. 136; no. 2; pp. 259 - 261
Main Authors:	Tolcher, Mary Catherine, McKinney, Jennifer R., Eppes, Catherine S., Muigai, David, Shamshirsaz, Amir, Guntupalli, Kalpalatha K., Nates, Joseph L.
Format:	Journal Article
Language:	English
Published:	United States Lippincott Williams & Wilkins 01-08-2020 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved
Subjects:	Algorithms Betacoronavirus Coronavirus Infections - complications Coronavirus Infections - epidemiology COVID-19 Female Humans Hypoxia - therapy Lung - physiopathology Pandemics Patient Positioning Pneumonia, Viral - complications Pneumonia, Viral - epidemiology Positive-Pressure Respiration Pregnancy Prone Position Respiratory Distress Syndrome - therapy SARS-CoV-2
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Summary:	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 pregnancy are taken into account.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	0029-7844 1873-233X
DOI:	10.1097/AOG.0000000000004012