Comparative analysis of the effectiveness of some intensive care methods in pregnant women with severe and extremely severe forms of coronavirus infection

Objective: to analyze the effectiveness of intensive care methods for severe forms of coronavirus infection in pregnant women. Material and methods: a cohort single-center prospective-retrospective study was conducted, including 83 completed clinical cases of the retrospective part and 54 patients of the prospective part. All patients were divided into 3 risk groups for an unfavorable outcome (low, medium and high), based on the value of the prognostic index. The group of patients with medium and high risk was divided into subgroups depending on the intensive care provided. The effectiveness of treatment in the study groups was assessed based on mortality rates, the duration of treatment of patients in the intensive care unit and intensive care unit, as well as the frequency of transferring the patient to artificial ventilation. Results. In the medium-risk group, the use of surfactant (group 2A) and the combined use of surfactant and a single administration of tocilizumab (group 2B) in addition to basic therapy turned out to be more effective than basic treatment alone (group 2B). At the same time, no statistical differences in the effectiveness of these two approaches were found. In the high-risk group, a comprehensive approach (group 3B), including extracorporeal treatment methods and multicomponent anti-inflammatory therapy, turned out to be more effective than anti-inflammatory therapy alone: tocilizumab twice (group 3A) and tocilizumab in combination with pulse therapy with methylprednisolone. Conclusion. Dividing patients into prognostic groups and conducting early complex therapy helps to reduce maternal mortality, the duration of treatment in the intensive care unit, and prevent excessive therapeutic aggression.