{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:33:43Z","timestamp":1761989623185,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,29]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>We describe the successful treatment of a 24-week pregnant, 44-year-old woman with COVID-19. Management of this complex case required multidisciplinary collaboration and included prolonged invasive mechanical ventilation and prone positioning. Caesarean section delivery was delayed for 32 days, with no monitored fetal compromise, while stabilising the mother. To our knowledge, this is the longest reported duration of invasive ventilation while pregnant in a patient with COVID-19. COVID-19 has been shown to cause increased disease severity in pregnant women, and certain pregnancy-related physiological adaptations that occur could help explain this association. While COVID-19 has been shown to cause no increased adverse neonatal outcomes, clinicians should be aware that data show increased preterm birth in symptomatic pregnant women, thereby increasing the chance of prematurity-related complications. Further research on COVID-19 in pregnancy is crucial to facilitate better management, and full inclusion of pregnant women in therapeutic clinical trials will help achieve this.<\/jats:p>","DOI":"10.1136\/bcr-2021-243516","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T22:50:14Z","timestamp":1631141414000},"page":"e243516","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Critical COVID-19 in a 24-week pregnant woman with 32 days of invasive mechanical ventilation before delivery of fetus: a case of successful collaborative multidisciplinary care"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5571-230X","authenticated-orcid":false,"given":"Kaladerhan Osemwengie","family":"Agbontaen","sequence":"first","affiliation":[{"name":"Intensive Care Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khevan","family":"Somasundram","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Baker","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,8]]},"reference":[{"key":"2025082623371497000_14.9.e243516.1","unstructured":"Coronavirus (COVID-19) Infection in Pregnancy [Internet] . Royal College of obstetricians and gynaecologists, the Royal College Fo midwives, Royal College of paediatrics and child health, public health England and public health Scotland, 2021. Available: https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/2021-02-19-coronavirus-covid-19-infection-in-pregnancy-v13.pdf [Accessed 10 Mar 2021]."},{"key":"2025082623371497000_14.9.e243516.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3320"},{"key":"2025082623371497000_14.9.e243516.3","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6944e3"},{"key":"2025082623371497000_14.9.e243516.4","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1002\/uog.23575","article-title":"Pregnant women with SARS-CoV-2 infection are at higher risk of death and pneumonia: propensity score matched analysis of a nationwide prospective cohort (COV19Mx)","volume":"57","author":"Martinez-Portilla","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2025082623371497000_14.9.e243516.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0251123","article-title":"The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: a national cohort study using the UK obstetric surveillance system (UKOSS)","volume":"16","author":"Vousden","year":"2021","journal-title":"PLoS One"},{"key":"2025082623371497000_14.9.e243516.6","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(20)31029-1","article-title":"Consider pregnancy in COVID-19 therapeutic drug and vaccine trials","volume":"395","author":"Whitehead","year":"2020","journal-title":"Lancet"},{"key":"2025082623371497000_14.9.e243516.7","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1152\/physrev.00024.2020","article-title":"Pregnancy and COVID-19","volume":"101","author":"Wastnedge","year":"2021","journal-title":"Physiol Rev"},{"key":"2025082623371497000_14.9.e243516.8","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.medmal.2020.05.004","article-title":"Serratia marcescens outbreak in the intensive care unit during the COVID-19 pandemic: a paradoxical risk?","volume":"50","author":"Amarsy","year":"2020","journal-title":"Med Mal Infect"},{"key":"2025082623371497000_14.9.e243516.9","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00017-11"},{"key":"2025082623371497000_14.9.e243516.10","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1002\/alr.21191","article-title":"Bacteria in the nose of young adults during wellness and rhinovirus colds: detection by culture and microarray methods in 100 nasal lavage specimens","volume":"3","author":"Allen","year":"2013","journal-title":"Int Forum Allergy Rhinol"},{"key":"2025082623371497000_14.9.e243516.11","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.ajog.2020.07.045","article-title":"Are clinical outcomes worse for pregnant women at \u226520 weeks' gestation infected with coronavirus disease 2019? 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Intensive care Society and faculty of intensive care medicine UK, 2019. Available: file:\/\/\/C:\/Users\/Wip%20User\/Downloads\/Prone%20position%20in%20adult%20critical%20care%202019.pdf [Accessed 10 Mar 2021]."},{"key":"2025082623371497000_14.9.e243516.17","doi-asserted-by":"crossref","first-page":"7","DOI":"10.4103\/joacc.JOACC_17_18","article-title":"Prone position ventilation in pregnancy: concerns and evidence","volume":"8","author":"Ray","year":"2018","journal-title":"J Obstet Anaesth Crit Care"},{"key":"2025082623371497000_14.9.e243516.18","doi-asserted-by":"crossref","DOI":"10.1016\/j.crwh.2020.e00273","article-title":"Use of dexamethasone, remdesivir, convalescent plasma and prone positioning in the treatment of severe COVID-19 infection in pregnancy: a case report","volume":"29","author":"Jacobson","year":"2021","journal-title":"Case Rep Womens Health"},{"key":"2025082623371497000_14.9.e243516.19","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/AOG.0000000000004012","article-title":"Prone positioning for pregnant women with hypoxemia due to coronavirus disease 2019 (COVID-19)","volume":"136","author":"Tolcher","year":"2020","journal-title":"Obstet Gynecol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243516","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:37:29Z","timestamp":1756276649000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243516"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":19,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9,8]]},"published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1136\/bcr-2021-243516"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243516","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,9]]}}}