Conclusion
Among the complexity of managing a pregnant intubated patient, COVID-19 adds additional challenges(26). With multiple treatment strategies going amiss(27), proning remains a well-proven intervention in ARDS and should be considered in pregnant women when indicated. In our case series, we were able to improve the P/F ratio while decreasing FiO2and avoid iatrogenic preterm delivery. Except for the case where the patient self-extubated and required emergent delivery, all patients were successfully extubated, followed for prenatal care, and delivered for usual obstetric indications. We recognize that proning might not be effective in all cases. However, based on its proven benefit in the non-pregnant population(7) and the available evidence in the pregnant population(8, 10, 13, 14), proning positioning is an option to improve oxygenation in patients with severe hypoxemia when the next consideration is delivery of a premature infant or maternal ECMO cannulation.