Recovering after 85 days of hospitalization

Recovering after 85 days of hospitalization

Orlando, Florida. –Paola Gambini arrived at Winnie Palmer Hospital for Women and Children in Orlando Health by ambulance on July 29, with a nearly complete pregnancy and a COVID-19 diagnosis, gasping for air.

“I remember the EMTs saying to us, ‘I called in time,’ because they immediately put me on oxygen,” she said.

Dr. Laurie Boardman, associate vice president and director of quality, said that from July 1 through September, about 260 pregnant patients with coronavirus were hospitalized in Winnie Palmer.

The South Central Florida division of AdventHealth saw a spike in COVID-19 patients during the summer delta wave, too. Dr. Catherine Berryman, a maternal-fetal medicine specialist, said the hospital admitted 113 pregnant women with complications from COVID-19 from July 1 to November 11, more than half the number hospitalized throughout the entire pandemic.

Nationally, from January 2020 to November 15, 2021, more than 145,000 pregnant Americans tested positive for COVID-19, and more than 24,000 were hospitalized, according to the Centers for Disease Control and Prevention. As of November 15, 229 pregnant women with COVID-19 have died.

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Boardman said pregnant and newly pregnant women are at risk because their immune systems are weaker than the average person.

Increasing evidence, though limited, has found that the benefits of the vaccine outweigh its risks for mothers and their babies, according to studies shared by the CDC on its website. In contrast, COVID-19 increases the risk of severe outcomes and premature birth compared to pregnant women without COVID-19, according to an analysis of 77 studies published in September 2020 in the BMJ Medical Research Journal. The Centers for Disease Control and Prevention said it is unlikely that children will catch COVID-19 from their parents.

However, despite the evidence, fewer than four in 10 pregnant women between the ages of 18 and 49 were fully vaccinated during or before pregnancy as of November 13, according to CDC data.

“If I could go back in time and know what I know now, I would definitely have gotten the vaccine,” said Gambini. “I don’t want other pregnant women to think, ‘I’m a superhero, I’m taking these vitamins… I’ll be fine, COVID won’t do me any good,’ because that’s exactly what I thought, and it’s not true.”

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fight covid-19

At first it was just a fever. But about a week after Gambini was diagnosed, she couldn’t catch her breath and fiancé Michael Hazen called 911. Her lungs were full of fluid.

Doctors performed an emergency caesarean section so that they could better administer the life-saving treatment to the 32-year-old girl. A girl was born prematurely before 37 weeks of pregnancy. They named her Liliana.

Gambini held Liliana briefly before her fiancé took her, and Gambini was transferred to Orlando Health Orlando Regional Medical Center. There she breathes a ventilator. When that wasn’t enough, doctors used an extracorporeal membrane oxygenation (ECMO) machine to pump her blood out of her body and oxygenate it there before returning it inside. The staff told her fiancé at several points that she might not be able to do so.

She said, “I feel so lucky to have left one piece…the nurses were telling me…you’re one of the lucky ones.”

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Her daughter became pregnant once when she was born, and once when her medical team arranged a visit for her birthday. Other than that visit, they only interacted via FaceTime.

“I just counted the days,” she said. “I remember them telling me, ‘You’re going home by Thanksgiving,’ and I remember looking at Michael, and I’m like, ‘I’m making it before Halloween, and I’m going to watch my kid get dressed up. And you did it.”

After 85 days, she went home. Liliana was wearing a pumpkin costume.

Gambini has now spent about a month at home with her baby. She’s on oxygen, and struggling physically after spending too much time in bed; She lost about 80 pounds, and her muscles atrophied. Doctors had to perform a partial hysterectomy in the hospital to stop the internal bleeding.

“I planned to have more children. … I’ve always wanted to be a mother. So for me to wake up and say, ‘We have to get your womb out,’ that was the hardest I’d ever hear,” she said. “She’s my rainbow baby, my only child.”

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But she’s getting better, and her goal is to be off oxygen by Christmas. She said she wants other people who’ve spent time in the hospital to know recovery is possible – but she also hopes other moms and dads don’t end up there.

fight misinformation

Boardman and Breeman said one of the big barriers to pregnant women getting COVID-19 is misinformation about vaccines. They urge clinicians to continue talking to unvaccinated patients.

“We’re not seeing any increase in birth defects or things like that as a result of comparing immunized women to unimmunized women,” Boardman said. “I still think some of those concerns remain, despite talking about what we know, as well as what we don’t know.”

A November Kaiser Family Foundation poll found that 17% of Americans think pregnant women should not get the COVID-19 vaccine, and 22% are unsure.

Representative Angela “Ange” Nixon, D-Jacksonville, blames politicians for spreading lies about COVID-19.

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Nixon contracted COVID-19 while pregnant. According to the Kaiser Family Foundation, pregnant Blacks and Hispanics have the lowest rates of COVID-19 vaccination and are also more likely to have complications during pregnancy.

“I know how scared it was for your life. Black women are four times more likely to have problems with pregnancy, and couples with COVID, it just gets worse.” “It is a shame that they are politicizing this.”

DeSantis signed a law Thursday allowing employees at private companies to opt out of vaccine mandates if they are pregnant or plan to become pregnant. The legislation also placed several other limitations on vaccine mandates.

Nixon said the legislation was “ridiculous” because it implied that vaccination harms pregnant women.

“It was a real slap in the face, especially for pregnant women,” Nixon said. “They are spreading lies.”

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Additionally, a page on the Florida Department of Health’s website differs from the CDC on this issue.

It has a page on high-risk populations that states that pregnant women “are known to be at risk of severe viral disease”, but “so far no data for COVID-19 have shown an increased risk”. However, it correlates with a CDC statement that states that it is a “fact” that pregnant or newly pregnant women with COVID-19 are more likely to develop serious illness than those who are not pregnant.

The Florida Department of Health did not respond to a request for comment on why it expressed the risk differently than the CDC.

As for whether it’s a good idea for pregnant women to let their guard down now that the summer wave in Florida has subsided, Boardman reminded everyone that the delta wave also started after a period of low positivity rates. She said COVID-19 vaccines and boosters will likely become as vital during pregnancy as flu vaccines are now.

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“(Don’t be lulled into a false sense of security, realizing this is going to be part of the world we live in, to take these precautions to help prevent what happens to these mothers,” Boardman said.

Berryman agreed that although COVID-19 cases are currently down, the pandemic will inevitably continue to follow the trend of upland, then valley, then up again, and pregnant women will be especially vulnerable without vaccination.

“I haven’t yet found a pregnant patient who regretted getting vaccinated,” Berryman said. “Universally they said…” I am so glad I understood that. “I only have patients who regret not receiving it.”

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