Mom and Baby's Tale of Survival After Severe COVID Strikes in Pregnancy
WEDNESDAY, April 14, 2021 (HealthDay News) -- The emotional toll of having a baby can be huge under any circumstance, but what if you didn't know you gave birth until two weeks later, and you weren't able to hold your baby in your arms for more than a month?
That was the reality for Yvette Camacho of Fontana, Calif.
She contracted a severe case of COVID-19 when she was nearly seven months pregnant and had to have an emergency cesarean section under general anesthesia in an effort to keep her and the baby alive.
Before she got the virus, Camacho was a healthy 30-year-old experiencing a normal pregnancy -- albeit one during a global pandemic. As an employee at a patio furniture company, she shifted between working from home and going to the office while raising her 7-year-old son, Ethan, with help from her longtime boyfriend.
In January, after a couple of her coworkers came down with COVID-19, Camacho and Ethan tested positive for the virus. While Ethan had no symptoms, Camacho felt progressively worse. It started with a headache, followed by chills the next day and an uncontrollable fever the day after. Soon, she lost her appetite, and debilitating fatigue kept her confined to her bed.
"I just kept getting worse and worse every day that came by," Camacho said. "I was scared because everything I was reading and hearing from family members was that people that got COVID, they went to the hospital, and they never came back out. So I was really scared for that."
Despite her hopes of avoiding the hospital, Camacho was left with no other option, as her fevers continued to spike and she grew short of breath. When she arrived at nearby San Antonio Regional Hospital on Jan. 15, doctors told her she had already developed COVID pneumonia.
Extraordinary steps to save mother and baby
Camacho was put under anesthesia and intubated to help her breathe.
"Everything just went by so quick after that," she recalled. "They explained to me the process of the intubation, but after that, I don't remember anything else when they put me in the coma." She would wake up two weeks later, under very different circumstances.
After Camacho was put into a medically induced coma, doctors decided it would be best to airlift her to Cedars-Sinai Medical Center in Los Angeles.
That's where Dr. Melissa Wong, a maternal-fetal medicine specialist, took over.
"We got the call from San Antonio Regional Hospital, a smaller hospital in our region, that there was a woman who had COVID and was 29 weeks pregnant and was getting sicker," Wong recalled.
Within eight hours of her arrival at Cedars-Sinai, Camacho's condition became increasingly unstable. To sustain her life, she would need the help of a machine known as ECMO, short for ExtraCorporeal Membrane Oxygenation. It works as a patient's heart and lungs when these organs are malfunctioning.
But putting a pregnant patient on ECMO can endanger both mother and baby, so Wong and her colleagues decided it would be best for her to deliver the baby via emergency cesarean section.
In real time, doctors made these decisions quickly, and there was no time to move Camacho to an operating room. Instead, they did the surgery in her room in the intensive care unit. Wong noted that this was highly unusual but necessary.
"We literally converted her little ICU room into an OR room using the tray table that we take our lunches and dinners on with some sterile drapes," she recalled.
An improvised — and intense — delivery
More than two dozen doctors and nurses filled the room and the hallway outside. Wong's team, who would help her perform the C-section, was the smallest. There was also the ECMO team, who would take over Camacho's care after the baby was born, and members of the Neonatal Intensive Care Unit (NICU), who would manage the baby's health.
The NICU team was working under especially unusual circumstances, Wong said. Not only was the baby was very premature, making the risk of health complications high, she had also been exposed to the anesthesia her mother received. That meant the baby would be unable to breathe on her own once she was delivered and would need immediate resuscitation and intubation.
"They basically had to work in the hallway nursing station and re-create their space, with their resuscitation equipment, respiratory equipment -- everything for a 29-weeker, which is already acute enough," Wong said. "It was intense."
That day -- Jan. 21 -- Camacho's daughter Emery was born. But Camacho didn't know that yet.
It would be 10 days later before Camacho was well enough for medical personnel to remove her breathing tube and take her off the anesthesia.
But as she adjusted to her new reality, Camacho had difficulty grasping all that had happened. When the nurses showed Camacho photos of Emery, she rejected the idea that this baby was hers, and all she could think about was her son.
"Everything was still blurred. I felt lost. I felt confused. I didn't know what hospital I was in," Camacho recalled. "I didn't know really what had happened or what I had just undergone."
Day by day and little by little, as Camacho and Emery recovered in different units of the same hospital, Camacho got to know her baby through video calls arranged by the hospital staff.
Soon after Camacho was well enough to leave the hospital, Emery followed and was transferred back to San Antonio Regional Hospital.
"Me and her dad decided to meet her at the same time, so shortly after she got transferred, we went and finally met her," Camacho said. "It was amazing -- very, very heavy on my heart."
A new mom's life after COVID-19
Now, Camacho, Emery and Ethan are settled at home together. Camacho still deals with lasting effects of COVID, including shortness of breath, headaches, body aches and trouble walking. Emery is perfectly healthy.
Soon, the baby will be 3 months old. If the pregnancy had gone according to plan, Emery would be a newborn. "On April 6, she would have been considered a full-term baby at 40 weeks," Camacho said.
Due to Camacho's treatments at the hospital, her doctors said she could not get a COVID-19 vaccine for some time, and she hasn't given much thought to it. But she feels a pang of anxiety every time she sees someone who is pregnant.
"After everything I went through, when I see a pregnant girl, I'm just like, 'stay home,'" Camacho said.
While pregnant women face a higher risk of severe illness from COVID-19, the risk remains relatively low.
Of the more than 83,000 pregnant women in the United States who have contracted COVID since January 2020, there have been 94 known deaths, according to the U.S. Centers for Disease Control and Prevention. While that's likely an undercount, the CDC has tallied more than 14,000 hospitalizations among pregnant women with COVID and 400 cases requiring intensive care.
Despite all this, pregnant women were excluded from many of the COVID-19 vaccine trials, making it difficult for doctors to give them clear guidelines on vaccine safety. Instead of protecting pregnant women from research, Wong said the model should be protecting them through research.
Still, most doctors and all major organizations in this field, such as the American College of Obstetricians and Gynecologists, support vaccination of pregnant women.
"The data suggests that the vaccine should be considered safe and should be offered to pregnant people," Wong said. "And, if you also ask any pregnant obstetrician-gynecologist that I know, they were like, 'I'll take it in my eye if you give it to me.'"
Camacho said she feels much the same way.
"I'm all for the vaccine if it means that it's going to prevent other women from getting as critical as I was," she said.
To learn more about COVID-19 and pregnancy, visit the U.S. Centers for Disease Control and Prevention.
SOURCES: Yvette Camacho, Fontana, Calif.; Melissa Wong, MD, obstetrician-gynecologist, maternal fetal medicine, Cedars-Sinai Medical Center, Los Angeles