RESUMO
Coronavirus disease 2019 (COVID-19) causes the development of severe acute respiratory distress syndrome. Pregnant women may be at increased risk for the development of severe disease. We present the case of a pregnant patient who developed respiratory failure due to COVID-19 and rapidly decompensated requiring intubation. Despite mechanical ventilation, the patient's respiratory status continued to worsen. At bedside, cardiothoracic surgeons, obstetricians, intensivists, and neonatologists discussed balancing the risk of COVID-19 and respiratory failure to the patient, premature delivery to the neonate, potential coagulopathy associated with COVID-19, and the need for anticoagulation with mechanical circulatory support. Ultimately, the decision was to proceed with emergency cesarean section delivery in the intensive care unit followed by peri-partum veno-venous extracorporeal membrane oxygenation initiation. The patient and neonate were both discharged home in stable condition.