Extracorporeal membrane oxygenation in obstetrical patients: a meta-analysis

Critically acute and ill and Obstetrical patients constitute a unique clinical population with a high mortality rate. Extracorporeal membrane oxygenation (ECMO) is gradually being used in obstetrical acute and critically ill patients and has shown great advantages. PubMed, Embase, Web of Science, Chinese CNKI Database, and Cochrane Library databases were systematically searched from the earliest available date to March 15, 2024, to obtain relevant studies on extracorporeal membrane oxygenation in obstetric patients. After screening the literature, data were independently extracted and summarized using random effects or fixed effects models, depending on the magnitude of heterogeneity. A total of 38 studies (917 patients) were included. The overall survival rate for critically ill obstetric patients supported by ECMO was 65% (56-74%). Among these, the survival rates for antepartum and postpartum patients were 70% (55-84%) and 63% (47-78%) respectively. The survival rates of obstetric patients supported by VV-ECMO and VA-ECMO were 70% (56-83%) and 56% (44-68%), respectively. This article systematically reports the survival rate of critically ill obstetric patients under ECMO support. The survival rate for these patients is significantly higher than the overall survival rate of all patients receiving ECMO support. Survival rates were similar for prenatal and postpartum patients but survival rates for patients supported by VV-ECMO were significantly higher than those supported by VA-ECMO. Further research is needed to explore the benefits of ECMO for obstetric patients with different disease types.