Acute respiratory distress syndrome in pregnancy

Oxygen saturation in pregnant individuals with COVID-19: time for re-appraisal?

Managing pregnant individuals with acute respiratory disease secondary to COVID-19 has been a challenge. Most professional societies including the Society for Maternal-Fetal Medicine recommend keeping O₂ saturation at ≥95% in pregnant individuals. Reaching this target has been increasingly difficult in some patients, especially during the latest wave of infections attributed to the delta variant of SARS-CoV-2. In the absence of adequate supporting data, and in the setting of a reassuring fetal status, we propose that maternal O₂ saturation should be maintained between 92% and 96% for admitted patients with acute respiratory failure who require supplemental O₂. This may prevent unnecessary invasive interventions that might not hold maternal or fetal benefit, specifically at very preterm gestational ages.