Experience of extracorporeal membrane oxygenation in obstetrics and gynecology

Abstract

Objectives. In severe cardiac and pulmonary insufficiency extracorporeal membrane oxygenation (ECMO) is increasingly used in gynecological, pregnant and postpartum patients, although the management of such patients and clinical results remain underestimated. This study presents the experience of ECMO in gynecological and obstetric patients in the peripartal period.Methods. This study included all obstetric, pregnant or postpartum patients who received ECMO support in the Department of anesthesiology and intensive care unit between 1 November 2009 and 1 September 2019. The data were analyzed retrospectively. The preliminary task was to describe the circumstances and clinical characteristics of patients receiving ECMO, describe the management of such patients during pregnancy, childbirth and the postpartum period, evaluate the results of treatment of mothers and fetuses and report bleeding and thrombotic complications.Results. During the study period, seven obstetric and gynecological patients were treated with ECMO. Including two pregnant, 4 postpartum and 1 gynecological. The mean age was 27.0 years and the average gestational age of pregnant women was 27.5 weeks. Five patients (71.4%) were discharged from the hospital with full recovery. The fetal survival rate in the group of pregnant and postpartum 85 was 5 (80,8%). One patient was successfully delivered to ECMO. Hemorrhagic complications developed in 3 patients (42.8%) and were associated with disseminated intravascular coagulation. There were no complications in the fetus associated with ECMO.Summary. In the work of a multidisciplinary team of experienced specialists ECMO can be used in gynecology, in pregnant women and in the postpartum period, outweighing the risks of bleeding or thrombosis, with favorable results for the mother and fetus.