Unprecedented childbirth of a pregnant woman in a coma due to Covid-19
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Diogo Ayres de Campos, Director of Obstetrics in Santa Maria and Professor at FMUL was responsible for the unprecedented childbirth of a pregnant women in a coma due to Covid-19

 

How is it possible to deliver a child of a woman in a coma infected with SARS CoV-2? Professor Diogo Ayres de Campos and his team explain all the details in a large article in Observador, which takes us behind the scenes of an unprecedented operation.

registo de nascimento de recém-nascido
Image credits: Observador

 

The birth, rare in the world, occurred in an equally unusual circumstance, with the pregnant woman in an induced coma, connected to a ventilator and artificial lung.

The doctors responsible for the childbirth at Santa Maria Hospital, and the parents involved in this unique story in the world, tell, in detail how it all happened and reveal the main difficulties and fears they felt before and after the decision, upon which hung the uncertainty of a happy ending.

In an interview with Observador, Professor Diogo Aryes de Campos, Director of Obstetrics at Santa Maria Hospital, explained that the difficult decision about when to perform the caesarean section was left to him. There was no certainty as to whether mother and child would survive, as the risk of bleeding was very high, but waiting longer could be a risk for both, he explained.          

 “As far as possible, we postponed the decision for 10 days, with a lot of pressure from the whole team, because it was feeling nervous”, he said, highlighting “the very little experience worldwide of pregnant women with Covid-19 receiving ECMO support”.

With the "daily pressure" to end the pregnancy, the option was "to play safe in terms of oxygenation of the baby". "There may be some more risk of complications, but at least the baby will not have a serious complication ‘in utero’, said the Professor in the piece, which shows the operating room used for pregnant women with SARS CoV-2.

Elisângela was infected at 27 weeks of gestation. She woke up from a coma when her son was 16 days old, when she first saw him in a video call.

“The virus hit the family in October, following a gesture of altruism and carelessness. The father [Adalberto] received a call from a sick friend, asking if he could go to the chemist to buy medicine for him, and he agreed. He went into his friend's house without wearing a mask. His wife immediately sensed that it had been a mistake and said to him: "You are doomed, you have become infected. If he has had a fever for three days and it does not go down, forget it, that’s it...", it can be read in the article.

When she was transferred to Santa Maria Hospital due to lack of vacancies at Beatriz Ângelo Hospital in Loures, where she was first admitted, the doctors realized that they had a complex case in hands and a very serious challenge ahead. Despite the absence of risk factors and being a young and healthy woman, Elisângela's situation worsened very quickly, forcing doctors to connect her to a ventilator.

homem segura bebé ao colo sob olhar atento da mulher
Adalberto holding his son with Elisângela looking at them, on the day they were discharged from Santa Maria Hospital on 8 January. Image credits: Observador

 

According to the scientific literature, there are about five dozen cases worldwide of ECMO use in pregnant women, quotes Observador. However, all of these cases took place before the Covid-19 pandemic and at different stages of pregnancy.

In the context of the current pandemic, a case was recorded in Poland, where the infected mother, also connected to the device, gave birth. In fact, there may have been other cases similar to Elisângela's, but they have not yet been made public. And because it is a rare situation worldwide, the specialists from Santa Maria are now preparing a scientific article in order to be an example to other countries.

Find out more details about this unique operation in the world and find out HERE the incredible story of baby Neves.