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CASE REPORT
Year : 2022  |  Volume : 46  |  Issue : 2  |  Page : 80-84

Cytokine storm secondary to coronavirus disease-19 pneumonia in a preterm pregnancy: A management and bioethical dilemma


Department of Obstetrics and Gynecology, Delos Santos Medical Center, Quezon City, Philippines

Correspondence Address:
Dominica Louise A. Sumera
Department of Obstetrics and Gynecology, Delos Santos Medical Center, 201 E. Rodriguez Sr. Avenue, Quezon City
Philippines
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/pjog.pjog_17_22

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A 27-year-old primigravida at 26 weeks' age of gestation presented with difficulty of breathing, nonproductive cough, and generalized body malaise. Coronavirus disease-19 (COVID-19) infection was confirmed by a positive reverse transcription-polymerase chain reaction. She was diagnosed with severe COVID-19 pneumonia with progressive oxygen desaturation requiring intubation and intensive care unit admission. The management and bioethical dilemma involved the use of investigational therapeutic interventions for compassionate use, with unknown effects to the fetus, namely remdesivir, tocilizumab, dexamethasone, and hemoperfusion to manage the cytokine storm and prolong pregnancy or to terminate the pregnancy hoping that it might improve the deteriorating condition of the patient. A multidisciplinary approach and family conference to solve the dilemma resulted in a successful outcome.


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