Case #3
A 39 y/o Hispanic G7P4024 with PMH of obesity and asthma presented at 27w6d admitted with COVID-19 respiratory symptoms. Patient oxygen requirement escalated quickly, and intubation was performed less than 48 hours after the presentation. On day five of mechanical ventilation patient self-extubated and was re-intubated. On day seven, the patient was proned for 16 hours due to worsening respiratory status (while less evident on arterial blood gasses, the patient had intermittent SpO2 drops to 80%, requiring temporary increases in FiO2 to 100%). Upon supination, the P/F ratio dropped from 258 to 155. However, no further proning was necessary as the respiratory status improved (P/F ratio >200 at FiO2 of 40-45%) (Figure S 2). Two days later, during a sedation holiday, the patient again self-extubated. The resultant prolonged acute hypoxia was complicated by fetal bradycardia and an emergent bedside cesarean delivery at 29w2d. The patient was extubated on postoperative day four and discharged home on day seven.