Infeccion Por Sars-Cov-2 En La Paciente Obstetrica: Una Perspectiva Desde El Cuidado Critico

Borre, Diana; Santacruz, Jose; Gonzalez-Hernandez, Jeniffer; Anichiarico, Walter; Romero, Jorge Rubio

ABSTRACT The new coronavirus infection (COVID-19) is currently the leading public health problem in the world. Between 5% and 30% of patients affected by this disease require management in an intensive care unit. Different documents have been published with recommendations for the general population. However, in the obstetric patient, the scientific evidence is limited, and even more so when it comes to COVID-19 infection in obstetric intensive care settings. For this reason, an unsystematic narrative review of the literature was performed using MEDLINE, scientific societies, as well as the repositories of the World Health Organisation and the Ministry of Health and Social Protection of Colombia as sources of information, in order to describe the management of a pregnant patient with COVID-19 in an intensive care unit. It is emphasised that care must be carried out by a multidisciplinary team, using maternal and fetal monitoring when appropriate. It is also suggested that there must be monitoring of oxygen saturation and maternal haemodynamics in order to minimise fetal hypoxaemia. A description is also presented of some recommendations on relevant topics in the critical scenario that include, among others, timely intubation, the adequate use of Personal Protective Equipment (PPE), the management of circulatory failure, as well as fluid and vasopressor restriction strategies.