Extracorporeal Membrane Oxygenation in Pregnant Women With COVID-19

Abstract INTRODUCTION: There are no reports regarding a pregnant woman with fulminant myocarditis underwent Extracorporeal Membrane Oxygenation (ECMO). Hence, we report a case of successful ECMO treatment of fulminant myocarditis puerpera. CASE PRESENTATION: A 32-year-old puerpera was admitted to our hospital with menopause for 7 months, fetal movement for 3 months and fever for 1 day. After admission, the patient's body temperature increased repeatedly, heart rate increased, and the whole process C-reactive protein increased rapidly. Considered a diagnosis of fulminant myocarditis. After antiviral and cardioprotective treatment, the heart function progressively worsened. Pregnancy was terminated, the newborn was intubated in the neonatal room for rescue after surgery, and ECMO treatment was given after the puerpera was transferred to the intensive care unit. Finally, the patient and the baby have been safely discharged from hospital. DISCUSSION: ECMO can provide cardiac and respiratory support. Fulminant myocarditis is common in children, adolescents and particularly pregnant women who had the highest mortality rate. In the pregnant woman with fulminant myocarditis described in this report, antiviral treatment only transiently improved heart function and then heart function progressively worsened. After receiving ECMO therapy, the patient's cardiac function has improved markedly. The patient was then successfully weaned from ECMO. To our knowledge, this is the first report of pregnant woman in whom ECMO was part of the treatment for fulminant myocarditis. CONCLUSION: We report a case of successful ECMO treatment of fulminant myocarditis puerpera. ECMO can be the treatment of choice for pregnant women with fulminant myocarditis.

Download Full-text

Experience of extracorporeal membrane oxygenation in obstetrics and gynecology

Innovative medicine of Kuban ◽

10.35401/2500-0268-2019-16-4-6-11 ◽

2019 ◽

pp. 6-11

Author(s):

A. A. Skopets

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Pregnant Women ◽

Postpartum Period ◽

Clinical Results ◽

Pulmonary Insufficiency ◽

Fetal Survival ◽

Membrane Oxygenation ◽

Results Of Treatment ◽

Thrombotic Complications ◽

The Mean

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.

Download Full-text