ECMO in Obstetrics

Emily E. Naoum, Amir A. Shamshirsaz, Luis D. Pacheco

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

During the recent COVID-19 pandemic, infection in pregnant and peripartum women resulted in higher risk for preterm birth, preeclampsia, cesarean delivery, perinatal death, intensive care admission, and need for invasive treatments such as mechanical ventilation or extracorporeal membrane oxygenation (ECMO). The two main modalities of ECMO that are currently used in clinical practice are venous-venous ECMO (VV-ECMO), which provides respiratory support, and venous-arterial ECMO (VA-ECMO), which provides both respiratory and circulatory support. This chapter discusses the basic components of each and their potential application in the obstetrical population and evaluates the existing evidence regarding the use of these modalities. Compared to VV-ECMO, the use of venoarterial ECMO (VA-ECMO) during pregnancy is far less common, and very limited data are available to guide management. A fundamental concept in VA-ECMO with peripheral cannulation is the possibility of developing Harlequin syndrome. Bleeding is a near-universal complication in patients undergoing ECMO.

Original languageEnglish (US)
Title of host publicationCritical Care Obstetrics, Seventh Edition
Publisherwiley
Pages328-334
Number of pages7
ISBN (Electronic)9781119820260
ISBN (Print)9781119820246
DOIs
StatePublished - Jan 1 2024

Keywords

  • bleeding
  • extracorporeal membrane oxygenation
  • Harlequin syndrome
  • pregnancy
  • venous-arterial ECMO
  • venous-venous ECMO

ASJC Scopus subject areas

  • General Medicine

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