A woman who is critically ill with COVID-19 and was pregnant is now at the MUHC on a type of life support, after doctors at the Jewish General Hospital decided it was safest to deliver her baby prematurely, CTV Nexjmtzywws has learned.
The baby, born about two months before the due date, was transferred to the same health centre and is being cared for in the pediatric intensive care unit at the Montreal Children’s Hospital.
The woman first arrived at the Jewish General Hospital a few weeks ago and after being admitted to the ICU was soon placed on a ventilator, according to a source within Montreal’s health-care community who was not authorized to speak publicly but who told the story to CTV News.
Information provided to the hospital indicated the woman was unvaccinated, the professional said. CTV was unable to speak with the family.
Despite the intensive care provided, her overall condition did not improve and her oxygen levels worsened.
As a result, after about a week, a decision was made to perform a caesarian section on the intubated woman for her benefit and the child’s, even though the woman was only 30 weeks pregnant.
As her health continued to deteriorate, she was transferred to the MUHC where she could be placed on ECMO (extracorporeal membrane oxygenation), according to two additional sources, which is a type of therapy that goes well beyond ventilation.
Once a patient is connected to the tubes and machine, the ECMO system adds oxygen to the blood and pumps it through the body, replacing the heart and lungs.
The treatment is used for a select group of patients and is seen as a last resort.
PREGNANT AND UNVACCINATED: SIX TIMES HIGHER RISK OF ICU ADMISSION
“I’m very sad to hear this story,” said Dr. Isabelle Boucoiran, an obstetrician-gynecologist at Ste-Justine Hospital, who is also a member of the infectious diseases committee of the Society of Obstetricians and Gynecologists of Canada (SOGC).
Boucoiran is not surprised to hear about the case, however, given the amount of time she still spends trying to convince about half the pregnant patients in her clinic who are hesitant, to get fully vaccinated.
“Yes, there are still adverse outcomes related to COVID and pregnancy, people need to be aware of that and act on that,” the specialist said.
“I’m not frustrated yet, sometimes I’m tired, “ she said.
Boucoiran said it’s not about assigning blame, but rather about figuring out how to get across the message to each pregnant woman who walks through the door.
To accomplish that she makes use of all the strong information out there now, on safety, efficacy and the considerable risks of being unvaccinated.
“Compared to women of the same age, being pregnant means a six times higher risk of being admitted to the ICU,” said Boucoiran, referring to the latest Canadian surveillance data that will be published within the next couple of weeks.
The elevated risks associated with COVID-19 infection also include an increased need for oxygen, hospitalization, and a significant increase in premature birth.
“There are also some cases of maternal deaths reported in Canada,” Boucoiran said.
Being adequately vaccinated can help prevent the dangers dramatically, she said.
“The vaccine works in pregnancy well, and women have less risk of severe COVID so it’s effective,” she said, adding that pregnant women have the same rate of side effects as anybody else. "There are basically no cases of adverse outcomes in [pregnant] women who have been vaccinated appropriately.”
That data refers to women who are two weeks past their second dose. The same safety profile applies to “neonates,” (newborns).
“So this is really reassuring,” she said, “and is what has been seen in other countries.”
VACCINE HESITANCY: ‘DON’T FEEL THEY’RE AT RISK’
Among the reasons women in her clinic give for not wanting to get vaccinated, fears about side effects and concerns about the effects on the baby’s health top the list.
Boucoiran has witnessed, however, that many of the women don’t think they’re at risk for catching the virus.
“Because they’re young, their husband or partner works from home. But the truth is especially with the Omicron variant, everybody’s at risk,” she said.
Pregnant women are no more likely to become infected than anyone else, but the Omicron variant is so contagious, she said, that even simple interactions with a delivery person at the front door, or with other children who attend daycare, the doctor suggested, make them vulnerable.
When that vulnerability combines with the physiological changes that occur in pregnancy, the risk of complications shoots up.
“We know the risk is mostly in the second and third trimester…related to [breathing] and also some immunity changes that explain this risk,” she said
She said it’s “difficult" at this point in the pandemic when she can’t get through to patients to whom she’s giving her best advice.
She says she tries “to stay focused on the topic because I think we can still improve the outcome of pregnancy in Canada and we can still improve our vaccination rate.”
