Extracorporeal membrane oxygenation and pregnancy

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Cardiology

Background:

• Pregnancy involves significant physiological changes that complicate critical illness management.
• Increasing maternal age and comorbidities contribute to a rise in cardiac disease during pregnancy.
• Infections like influenza and COVID-19 are leading causes of adult respiratory distress syndrome in pregnant individuals.

Purpose of the Study:

• To review the role and outcomes of Extracorporeal Membrane Oxygenation (ECMO) in managing critical illness during pregnancy.
• To highlight the challenges and necessary adjustments for ECMO use in the antenatal and postpartum periods.

Main Methods:

• Review of current literature and clinical practices regarding ECMO in pregnancy.
• Analysis of physiological adaptations during pregnancy impacting ECMO parameter adjustments.
• Discussion of multidisciplinary collaboration essential for optimal patient care.

Main Results:

• Extracorporeal membrane oxygenation (ECMO) provides crucial respiratory and/or cardiac support for pregnant patients with critical illnesses.
• Pregnancy-specific physiological changes necessitate tailored ECMO management strategies.
• Potential complications like bleeding and thromboembolism require careful monitoring and management.

Conclusions:

• Extracorporeal membrane oxygenation (ECMO) is a viable intervention for critically ill pregnant individuals.
• Favorable maternal and fetal outcomes are achievable with appropriate ECMO implementation and multidisciplinary care.
• Further research is needed to fully elucidate optimal ECMO management protocols in pregnancy.