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Updated: Aug 30, 2025

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Extracorporeal Membrane Oxygenation During Pregnancy.

Luis D Pacheco1, Amir A Shamshirsaz2,3

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Clinical Obstetrics and Gynecology
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Extracorporeal membrane oxygenation (ECMO) use in pregnancy is rising. Venovenous ECMO for respiratory failure shows reassuring outcomes, but data on venoarterial ECMO for combined support remain limited.

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Area of Science:

  • Critical Care Medicine
  • Cardiovascular Support
  • Respiratory Support

Background:

  • Extracorporeal membrane oxygenation (ECMO) use has increased globally in recent decades.
  • Pregnancy and postpartum periods have seen a rise in ECMO utilization, mirroring general trends.
  • Venovenous (VV) ECMO supports respiratory function in acute respiratory distress syndrome (ARDS) unresponsive to mechanical ventilation.

Purpose of the Study:

  • To review the current data on the use of VV and VA ECMO in pregnant and postpartum individuals.
  • To assess the safety and efficacy of ECMO during pregnancy and the postpartum period.
  • To highlight the limited data available for VA ECMO in this specific population.

Main Methods:

  • Literature review of studies on ECMO use in pregnant and postpartum patients.
  • Analysis of outcomes associated with VV ECMO during the COVID-19 pandemic.
  • Synthesis of available data on VA ECMO application in pregnancy.

Main Results:

  • VV ECMO use in pregnancy and postpartum has increased, with overall reassuring data, especially during the COVID-19 pandemic.
  • VV ECMO is utilized for ARDS when conventional ventilation fails.
  • Data regarding the use of VA ECMO, which provides both respiratory and cardiovascular support, in pregnancy is extremely limited.

Conclusions:

  • VV ECMO appears to be a safe and effective option for respiratory support in pregnant and postpartum patients with ARDS.
  • Further research is urgently needed to understand the risks and benefits of VA ECMO in pregnant and postpartum individuals.
  • The limited data on VA ECMO necessitates cautious application and further investigation in obstetric critical care.