Venovenous Extracorporeal Membrane Oxygenation to Prolong Pregnancy: A Case Report

We report a gravida in fulminant acute respiratory distress syndrome, mechanically ventilated at 27 weeks estimated gestational age, who further deteriorated into severe combined hypercarbic, hypoxemic respiratory failure. At 30 weeks estimated gestational age, she was placed on venovenous extracorporeal membrane oxygenation (ECMO) because of refractory respiratory failure. Her physical status improved without fetal deterioration. She was managed expectantly in an effort to allow continued fetal maturation. Six days later, complications of ECMO (pulmonary hemorrhage) led to emergent abdominal delivery of a living male child. She was successfully weaned from ECMO 8 days later. The implications of ECMO during pregnancy are discussed.