key: cord-0028187-u3hkr2nb authors: Eid, Joe; Costantine, Maged M.; Rood, Kara M. title: Considerations in pregnant individuals with low baseline oxygen saturation: a response date: 2022-02-23 journal: Am J Obstet Gynecol DOI: 10.1016/j.ajog.2022.02.026 sha: 3af2f8746323ac18f537ab20ab428ef9a4e73a4a doc_id: 28187 cord_uid: u3hkr2nb nan We would like to thank the authors for their comments on our recent publication. 1 We agree that it is very important to interpret the oxygen saturation in the setting of underlying maternal disease. Targeting a higher oxygen saturation in pregnancy in certain patients with baseline low levels of oxygen is not always feasible from a physiological standpoint. In addition to patients with a hemoglobinopathy described by the authors, other populations with congenital cyanotic heart disease, such as Eisenmenger syndrome, have decreased oxygen saturation in the systemic circulation. 2 Maternal oxygen saturation in these patients should be assessed and optimized throughout the pregnancy to avoid adverse maternal and fetal outcomes. Hence, determining the baseline maternal parameters (including oxygen saturation) at the beginning of the pregnancy is crucial for guiding management, especially during this COVID-19 pandemic. Oxygen saturation in pregnant individuals with COVID-19: time for re-appraisal? Management of pregnancy in patients with complex congenital heart disease: a scientific statement for healthcare professionals from the American Heart Association