Management of ARDS related to COVID-19
1. Ventilation settings were adjusted, considering physiologic changes of pregnancy. The SpO2 was maintained ≥ 94%(12). The goal for PaO2 was > 70mmHg and for PaCO2 < 50mmHg(12). In most cases, the decision for proning was made if the P/F ratio was < 150 on ≥ 60% FiO2 and ≥ 10 of PEEP(7). This should serve as a general rule for initiating and discontinuing proning sessions.
2. The principles of medical treatment are highlighted below and summarized in supplemental Catalog 1. Coverage for superimposed pneumonia was typically provided for patients that required increasing respiratory support. Remdesivir, Canakinumab, Tocilizumab, and convalescent plasma were offered based on inclusion criteria for treatment or clinical trial. Antenatal corticosteroids were administered between 24 and 34 weeks if there was a concern for imminent delivery.