About 70 percent of unvaccinated pregnant women currently in the UAB ICU are in ventilators.
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Doctors from the UAB Division of Maternal-Fetal Medicine report that 39 pregnant women have been admitted to the UAB Hospital this month. Of these, 10 are in the intensive care unit and seven of them with fans.
This is an extraordinary number of pregnant women for the UAB ICU, says Steve Stigler, MD, director of the Medical Intensive Care Unit at UAB Hospital.
“Really, we’ve never had this number of pregnant women in my ICU,” said Stigler, an associate professor at the UAB School of Medicine since 2012. “It’s alarming. In a regular month, we may have a or two pregnant women who need our care in a medical intensive care unit; but these are very rare circumstances. “
Unfortunately, these pregnant COVID patients, especially those in the ICU, have had to receive their babies prematurely. In some cases, babies are born the 26th week of a woman’s pregnancy. The full term is considered 37 weeks and 40 weeks is ideal.
“At any time, when we have women who are exceptionally ill, the rate of premature birth increases sharply,” said Akila Subramaniam, MD, an associate professor in the UAB Division of Maternal-Fetal Medicine. “What has increased the most in the last two months is that almost all of these women are having a premature birth, not because they are working before the trimester, but because we are having a premature birth because the virus is doing a lot of damage to these women “.
“If a mother doesn’t oxygenate her body well, she doesn’t oxygenate her baby either,” added Audra Williams, MD, an adjunct professor in the UAB Department of Obstetrics and Gynecology. “This is what can lead us to give birth to the baby. And there are many risks associated with prematurity: long-term neurological or gastrointestinal complications, among others. It’s not just the acute risk of COVID infection that these babies face, but the long-term risk of a lifetime.
To date, two COVID-positive women have died while pregnant at the UAB. Six other COVID-positive women have lost their baby during the second trimester. Three other COVID-positive women lost their babies during the third trimester.
Subramaniam says that in some cases, doctors have to perform a cesarean section in the ICU because they cannot safely work women in an ICU unit, especially when they need to be placed on a ventilator or a extracorporeal membrane oxygen machine (ECMO). The ECMO is similar to the heart-lung bypass machine that is commonly used in open-heart surgery. It pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest.
“If the mother needs to be intubated, it does not necessarily mean that the baby has to be delivered. But often what we are seeing is that there is a high rate of failure in intubation and it immediately worsens the maternal state after intubation, “Subramaniam said.” Often we have to do it under the pressure of col. place patients in ECMO and after delivery. And in some cases, if things deteriorate very quickly, we find ourselves giving birth in the head in the ICU in order to protect the baby while also taking care of the mother. It is not ideal to have a surgical treatment in an ICU center ”.
Click on the graph to enlarge it.According to data from the Centers for Disease Control and Prevention, pregnant women are among the highest groups of people who identify as hesitant. Currently, only 23% of pregnant women are vaccinated, according to the CDC.
None of the pregnant women in the UAB ICU are vaccinated.
Williams says he always talks to his pregnant patients about vaccination and its safety. He also understands that the decision is not easy. Subramaniam understands that too. No expectant mother wants to do anything that could harm her baby.
“The good news is that we have a vaccine that has been tested on more humans than any other vaccine in history,” Subramaniam said. “The vaccine is safe for pregnant women, regardless of the trimester they are in, and is safe for breastfeeding mothers. The data is compelling in this.
“You can rely on the medicine that protects you and your child from the extensive data that has been collected. These are very tough decisions, but now we have a lot more data than in December. We can definitely say, yes, that these vaccines are safe for women and their babies. “