Abstract: Background and Objectives: Coronavirus disease 2019 (COVID-19) is a novel infectious
disease that has spread worldwide. As of 5 March 2020, the COVID-19 pandemic has resulted
in approximately 111,767 cases and 6338 deaths in the Republic of Srpska and 375,554 cases and
15,718 deaths in Bosnia and Herzegovina. Our objective in the present study was to determine the
characteristics and outcomes of critically ill pregnant/postpartum women with COVID-19 in the
Republic of Srpska. Materials and Methods: The retrospective observational study of prospectively
collected data included all critically ill pregnant/postpartum women with COVID-19 in a universityaffiliated hospital between 1 April 2020 and 1 April 2022. Infection was confirmed by real-time
reverse transcriptase polymerase chain reaction (RT-PCR) from nasopharyngeal swab specimens and
respiratory secretions. Patients’ demographics, clinical and laboratory data, pharmacotherapy, and
neonatal outcomes were analysed. Results: Out of the 153 registered pregnant women with COVID-19
treated at the gynaecology department of the University Clinical Centre of the Republic of Srpska,
19 (12.41%) critically ill pregnant/postpartum women (median age of 36 (IQR, 29–38) years) were
admitted to the medical intensive care unit (MICU). The mortality rate was 21.05% (four patients)
during the study period. Of all patients (19), 14 gave birth (73.68%), and 4 (21.05%) were treated
with veno-venous extracorporeal membrane oxygenation (vvECMO). Conclusions: Fourteen infants
were born prematurely and none of them died during hospitalisation. A high mortality rate was
detected among the critically ill pregnant/postpartum patients treated with mechanical ventilation
and vvECMO in the MICU. The preterm birth rate was high in patients who required a higher level
of life support (vvECMO and ventilatory support).