Mrs. K, a 27-year-old pregnant woman at 27+4 weeks of gestation, presented to our obstetric emergency unit with tachypnea (RR 28×/min; saturation 92%) one day before admission. The patient also had a fever (103.1 °F) and cough 1 week before admission. Other than that, she also had chronic hypertension. A chest X-ray showed patchy consolidation that corresponded to bilateral pneumonia. A naso-oropharyngeal swab for SARS-CoV-2 was positive as tested by RT-PCR (RdRP Cq 35.15; E Gene Cq 32.10). The patient was taken care of in the High Care Unit (HCU) with oxygen therapy using 10 L per minute (Lpm) with a nonrebreathing mask (NRM), and O2 saturation maintained at 95–97%. She was diagnosed with acute respiratory distress and superimposed preeclampsia with severe features. The patient was treated with anti-hypertension (nifedipine 4 × 10 mg), MgSO4 for seizure prevention, and dexamethasone 2 × 6 mg for lung maturation for 2 days.\nOn hospital care day 2, tachypnea worsened (RR 32×/min), with a decreased O2 saturation to 90% while on oxygen therapy given at 10 Lpm with NRM. The patient had an emergency cesarean section, and a baby girl was born with a birthweight of 1150 g, birth length of 34 cm, and APGAR score (AS) 7/9. The baby was taken care of in the NICU isolation for COVID-19 as a naso-oropharyngeal swab for SARS-CoV-2 result was negative.\nFor postoperative observation, the patient was taken to HCU with no clinical improvement. On hospital care day 7 (HD 7), she was given Remdesivir protocol for 5 days. Tachypnea and saturation improved on HD 8 (RR 24×/min; O2 saturation 96% with NRM 6 Lpm). Both patient and baby were discharged on HD 12 after the SARS-CoV-2 swab came back negative.
Mrs. M, a 28-year-old pregnant woman at 36 weeks gestation, was diagnosed with confirmed COVID-19 and was referred to our hospital due to worsening clinical symptoms. The patient had been treated in a previous hospital for 2 days with symptoms of cough and fever 4 days before admission. During hospitalization, the patient’s condition worsened as she displayed tachypnea (RR 32×/min, O2 saturation 92%) and fever (102.2 °F).\nA chest X-ray showed no abnormalities in both lungs. A naso-oropharyngeal swab for SARS-CoV-2 was positive (N gene Cq 39.54). Oxygen saturation was 95% using oxygen therapy at 3 Lpm with a nasal cannula. An emergency cesarean section was directly performed due to the worsening of the maternal condition and oligohydramnios seen from ultrasound examination. The cesarean section was performed with no complications. A baby boy was born with a birthweight of 2345 g, a birth length of 45 cm, and AS 7/8. The baby was taken to perinatal isolation for COVID-19 with a negative result for SARS-CoV-2 from a naso-oropharyngeal swab.\nThe patient was taken care of in HCU after surgery on day 1 postoperative (HD 1). Remdesivir was directly given with a dose of 200 mg IV on the 1st day and continued with 1 × 100 mg IV on day 2 until 5. The patient’s postoperative condition was stable, and the RT-PCR result for SARS-CoV-2 was negative on HD 4. Both patient and baby were discharged on HD 7 after Remdesivir therapy was completed.