Pregnant Mom Survives Life-Threatening COVID Infection, Delivers Healthy Baby

ECMO Patient

Lorena Granados was ecstatic. She was pregnant once again, after a decade since the birth of her third daughter. While she and her husband, Horacio, had been given the gift of another baby, his birth wasn’t destined to be easy like the others.

At 20 weeks along, Lorena contracted COVID-19. She hardly felt sick at first; then a week later she passed out in bed, unable to breathe. Horacio rushed her to the emergency room of their local hospital in San Luis Obispo County, California, where she was admitted and put on a ventilator. Yet she didn’t get better. She got worse.

“The last thing I remember was hearing the doctors tell me they couldn’t care for me anymore and that I was going by helicopter to Stanford,” says Lorena. “I didn’t remember anything else until a month later when I woke up on ECMO.”

Doctors at Lucile Packard Children’s Hospital Stanford had a doubly challenging job: keep Lorena alive and keep her pregnant as long as possible. It was an incredibly challenging goal, even for a team that was used to providing the highest level of critical care for mothers and babies.

The first step was getting Lorena on extracorporeal membrane oxygen, or ECMO. It’s a sophisticated heart-lung bypass machine, which oxygenates the blood and then pumps it back into the patient’s body. It acted as Lorena’s lungs because her own lungs had quit working. ECMO is used as a lifesaving device, supporting the patient until the body recovers enough to function on its own. The typical length of time on ECMO is seven to 10 days. Lorena was on ECMO for 45 days.

If Stanford was not Stanford, this case would have been extraordinarily difficult to manage,” says Yasser El-Sayed, MD, obstetrician in chief. “It took all of us collaborating, sometimes minute by minute, to keep Lorena alive and keep her pregnant so baby Matthias could grow and survive.”

A vast circle of doctors and nurses surrounded mom and baby, each contributing their unique perspective. Meetings between specialty departments—cardiovascular intensive care, critical care, the ECMO team, obstetrics, maternal-fetal medicine, neonatology, and pediatrics—occurred several times a day to discuss Lorena’s condition. Stanford is unique in Northern California for offering two hospitals in one: an adult hospital physically connected to a children’s hospital with experts who are accustomed to walking down the hall and collaborating with one another. From the adult side, Lorena received intensive care for herself, and from the children’s side she received care for her baby. It was the right care in the right moment—just what Lorena and Matthias needed.

“Between the two hospitals, we specialize in both highly complex pregnancies and extraordinarily complicated neonatal conditions, and we’re delivering this care in a profoundly collaborative, coordinated manner. It’s one of our absolutely distinguishing features—something many children’s hospitals do not have—and it empowers us to provide exceptional outcomes,” says Susan Hintz, MD, medical director of the Fetal and Pregnancy Health Program. “Our deeply integrated approach enables us to seamlessly perform a difficult delivery followed by a swift hand-off into the waiting arms of neonatologists and other pediatric specialists who are ready to provide whatever care a newborn baby needs.”

The Johnson Center for Pregnancy and Newborn Services is nationally recognized for its research, best practices, and leadership in its focus area. Lucile Packard Children’s Hospital Stanford is ranked as one of the best hospitals in the nation with Neonatology ranked #3 in the United States, according to the 2021–2022 U.S. News & World Report Best Hospitals rankings.   

“Every day, we knew that call might come, summoning our large team of specialists to Lorena’s side to perform a major lifesaving measure,” Yair Blumenfeld, MD says. “You could say we were lucky, but if we were not in an institution that had the highest level of lifesaving technology and a top-quality team of life-support specialists, then luck alone doesn’t help.”

When Lorena was 29 weeks along, her husband got the call that he had to come to the hospital immediately. Lorena began having preterm contractions and the baby was in breech presentation, so a cesarean delivery had to be performed to deliver Matthias.

“They told Horacio that they had to act fast,” Lorena says. “So many hands were working together to keep us alive—it was a miracle.”

Performing a cesarean section while a mother is on ECMO is very different than a standard C-section. It’s rare—so rare that it was the first time in three decades that the Johnson Center’s labor and delivery team delivered a mom while she was attached to ECMO.  

“It was a very tenuous situation with a high risk of a poor outcome,” Dr. El-Sayed says. “With ECMO, the patient is put on blood thinners, which makes surgery difficult. Plus, Lorena was still very ill. It took the talents of a large team of clinical adult and child care specialists working together to ensure a happy ending.”

Baby in the NICU at Lucile Packard Children's Hospital Stanford

The team had met their goal. They kept Lorena alive on ECMO and delivered a robust premature baby. Matthias entered the world at 29 weeks—young, but not so young that he’d have serious complications. He spent several weeks in the Neonatal Intensive Care Unit (NICU), where he remained COVID-free and received help breathing to support his lungs and help him grow strong.

Despite a successful cesarean section, Lorena was not out of the woods. Within 24 hours from delivery, she started bleeding internally. Trauma specialists, trauma surgeons, and obstetric anesthesiologists were called to perform emergency surgeries over the next few days. Lorena was losing a lot of blood, and her lungs were still very sick.  Given the complexity of her case, these challenges were anticipated.

“Luckily, her lungs improved almost immediately once surgery was performed and the bleeding controlled,” Dr. Blumenfeld says.

Lorena remembers feeling depressed when she’d look down at her belly and see all the scars. Plus, she needed constant pain medication. She credits the doctors, nurses, and her family for keeping her going.

“The nurses were so loving and positive. If it were not for them, cheering me on, I’m not sure how I would have continued going,” she says. “I lifted myself up for my kids. My girls know me as a strong woman, and I didn’t want them to see me go downhill and deteriorate.”

After 10 weeks at Packard Children’s, Lorena was released home. Having spent nearly all of February to April 2021 in a hospital bed, she had a lot of recovering to do. She used a wheelchair and then a walker. She needed help doing everything, from toileting to cooking to cleaning. Horacio and her girls, Kaylin (16), Konnie and Kendall (13), stepped up and took over. Today, she’s pretty much back, and her doctors expect a full recovery. 

“It made us grow stronger as a family,” Lorena says. “I want people who go through tough medical times like this to know you can make it. Don’t let yourself think you won’t, because you will.”

A month later, Matthias was released from the NICU and joined them. As a preemie he needs extra care, but he’s doing exceptionally well.

“I was struck by Lorena’s incredible strength as she pulled through a severe case of COVID, and what a champ Matthias was as a premature baby,” says Ritu Chitkara, MD.

Lorena treasures her early-morning feedings with Matthias. He stares into her eyes, and they have sweet, private conversations.

“I’m taking in every single moment with him. He’s our last child, and we are so lucky to have him,” Lorena says. 


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