key: cord-0706773-tpt3p4x4
authors: DELLAPIANA, Gabriela; NAQVI, Mariam; LEGGETT, Cecilia; THOLEMEIER, Lauren; BURWICK, Richard M.
title: Preferential use of dexamethasone for fetal lung maturation in severe COVID-19
date: 2020-08-20
journal: Am J Obstet Gynecol MFM
DOI: 10.1016/j.ajogmf.2020.100218
sha: bd085136a3aa38c1776d536711d9fe77536b1879
doc_id: 706773
cord_uid: tpt3p4x4

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As of July 1, 2020, over 10 million cases of Coronavirus Disease 2019 (COVID-19) and 2 over 500,000 deaths have been reported to the World Health Organization. 1 The 3 Centers for Disease Control and Prevention found that pregnant women with COVID-19 4 were more likely to be hospitalized, admitted to the intensive care unit, and require 5 mechanical ventilation when compared to non-pregnant women of reproductive age with 6 COVID-19. 2 Preliminary data from the Randomised Evaluation of COVID-19 therapy 7 (RECOVERY) trial found that dexamethasone was associated with a reduction in 28-8 day mortality in patients requiring supplemental oxygen or mechanical ventilation. 3 It is 9 unclear if dexamethasone is similarly effective in pregnant women with COVID-19. for COVID-19, and she had been self-quarantining at home.

In the emergency department, her temperature was 37º Celsius, heart rate 102 beats 20 per minute, blood pressure 106/55 mmHg, respiratory rate 25 breaths per minute, 21 oxygen saturation 94% on room air oxygen, and body mass index 31 kg/m 2 . Repeat Table 1 ). Obstetric ultrasound showed normal 25 fetal heart rate and amniotic fluid volume, with estimated fetal weight of 1642g. She was 26 admitted to the inpatient unit and treated with nasal cannula oxygen at 2 L/minute, 27 enoxaparin at 1mg/kg/d, and modified prone positioning.

On hospital day 2, her dyspnea worsened, and oxygen was increased to 4.5 L/minute to 30 meet target saturation ≥95% for pregnancy. Compassionate use of remdesivir was On hospital day 5, she was transferred to the intensive care unit on 35 L/minute high 39 flow nasal cannula oxygen at 60% FiO2. Due to concern for impending respiratory 

COVID-19) dashboard [Internet]. Global situation. 76 [Accessed