Case series on successful anesthetic management of COVID-19–positive obstetric patients undergoing emergency cesarean section

Coronavirus disease 2019 (COVID-19) outbreak was first reported in Wuhan, and its manifestations in pregnancy can be variable ranging from mild illness to severe acute respiratory syndrome. Management of such patients depends on severity of illness and gestational age. Case 1: A 67-year-old elderly primigravida with multiple comorbidities (type 2 diabetes, hypothyroidism, and intrahepatic cholestasis of pregnancy) and mild COVID-19 infection presented for emergency cesarean. Cesarean was conducted under spinal anesthesia after taking due personal protective equipment (PPE) precautions. Both mother and baby were discharged successfully. Case 2: A 24-year-old lady with severe COVID-19 illness who presented for emergency cesarean section was taken up under regional anesthesia with continuous positive airway pressure (CPAP) support. Intraoperative course went uneventful, and the patient was discharged after 12 days of intensive care unit (ICU) admission. Choice of anesthesia for a cesarean section is preferably regional anesthesia, whether the patient is COVID-19 positive or negative. Symptom management and optimisation is necessary in preoperative period the patient for surgery. Involvement of a multidisciplinary team approach with ICU care is helpful in successful management of the patient.