COronaVirus Induced Acute Respiratory Disease Syndrome During PREGnancy

Study Overview
=================
Brief Summary
-----------------
Few data are available on the management of critically ill pregnant women with pneumonia related to SARS-CoV-2. In the absence of clear recommendations for the management of delivery, clinicians are faced with the risk of pregnancy continuation against the risk of premature birth. In these multicenter retrospective study, the investigators want to describe clinicians attitude on delivery management in pregnant women requiring invasive mechanical ventilation for acute respiratory distress syndrome related to SARS-CoV-2. Two strategies will be compared on maternal, obstetric and neonatal outcomes: Wait strategy defined by no extraction within 24 hours of invasive venting Early strategy defined by extraction within 24 hours of invasive ventin

Official Title
-----------------
COronaVirus Induced Acute Respiratory Disease Syndrome During PREGnancy

Conditions
-----------------
Acute Respiratory Distress Syndrome Related to SARS-CoV-2

Intervention / Treatment
-----------------
* Other: No intervention


Participation Criteria
=================
Eligibility Criteria
-----------------
patient > 18 years Patient with SARS-CoV-2 pneumonia proven by RT-PCR Hospitalization in an intensive care unit during pregnancy after 14 weeks' gestation Need for ventilatory support including: oxygen therapy > 6L/min and/or NIV and/or High Flow Oxygen and/or invasive mechanical ventilation +/- ECMO. Exclusion Criteria: Patient's refusal to participate in this study

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: No intervention|No intervention|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compare two fetal extraction strategies: - Wait strategy defined by no extraction within 24 hours of invasive venting - Early strategy defined by extraction within 24 hours of invasive venting | Assessment Criterion 1: Maternal prognosis assessed by: Mortality Duration of invasive mechanical ventilation Need for ECMO Use of prone position and/or nitric oxide and/or almitrine Adverse events: cardiac arrest, organ failure, thromboembolic episodes, nosocomial infections, barotrauma Length of stay in the ICU and in the hospital Assessment Criterion 2: Obstetric prognosis assessed by: Fetal extraction in the ICU room due to a contraindication to transport (maternal and/or fetal risk) Delivery route Peri partum hemorrhage Complications of obstetric anesthesias Assessment Criterion #3: Fetal Prognosis Assessed by: Term birth, Weight, Apgar, pH cord blood, Need for ICU admission, Death | 'Day 1. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patient requiring invasive mechanical ventilation with or without ECMO | Number of patient requiring invasive mechanical ventilation with or without ECMO | 'Day 1. | 
| Number of patients receiving pharmacological treatments for the management of COVID: corticosteroids, antivirals, anti-IL6, anticoagulants, antibiotics | Number of patients receiving pharmacological treatments for the management of COVID: corticosteroids, antivirals, anti-IL6, anticoagulants, antibiotics | Day 1. | 
| Evolution over time of the number of patients admitted to the ICU in the participating | Evolution over time of the number of patients admitted to the ICU in the participating centers (1st, 2nd, 3rd epidemic wave) | Day 1. | 
| Evolution over time of the number of patients admitted to the ICU in the participating | Evolution over time of the number of patients admitted to the ICU in the participating | Day 1. | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
COVID-19,, Acute respiratory distress syndrome, Pregnancy, Preterm delivery, SARS-CoV-2, ICU, Critical Care, Mechanical ventilation