A 29-year-old pregnant woman presented at 26 weeks of gestation with fever and cough for 4 days. On admission, her nasopharyngeal swab confirmed COVID-19. As her respiratory distress worsened, she was shifted to the intensive care unit (ICU). As the patient was unable to maintain saturation even on high settings of mechanical ventilation, she underwent venovenous extracorporeal membrane oxygenation (VV-ECMO) and was monitored in surgical ICU by a multidisciplinary team.

The obstetrical team was on standby to perform urgent delivery if needed. Her condition improved, and she was weaned off after 5 days on extracorporeal membrane oxygenation. She was observed in the antenatal ward for another week and discharged home with the mother and fetus in good condition. VV-ECMO can be considered as rescue therapy for pregnant women with refractory hypoxaemia of severe respiratory failure due to COVID-19. It can save two lives, the mother and fetus.

The patient had regular follow up till term and delivered a healthy 3.8 kg female baby by elective cesarean for obstetrics reason at 39 weeks with good APGAR scores. Her cesarean and postnatal course were uneventful and baby had no neonatal problems. This shows that VV-ECMO is a feasible option in management of serious Acute Respiratory Distress Syndrome (ARDS) in pregnancy.

Keywords: Acute respiratory distress syndrome (ARDS), Extracorporeal membrane oxygenation (ECMO), Pregnancy, Fetus.