Skip to main content
SpringerLink
Log in

Extracorporeal Membrane Oxygenation in Pregnancy

  • Chapter
  • First Online:
Obstetric Catastrophes

  • 718 Accesses

Abstract

Extracorporeal membrane oxygenation for rescue therapy, in pulmonary and cardiopulmonary failure, has been well described in the literature. Improvements in technology and critical care have allowed for increased utilization secondary to improvement in clinical outcomes (Mosier et al. Crit Care 19:431, 2015). To date, application for special populations, such as in obstetric patients, is not clearly defined (Pacheco et al. Semin Perinatol 42(1):21–5, 2018). Multiple case reports have been published supporting ECMO use in pregnancy and the peripartum period. In this chapter, the basics of ECMO will be discussed along with its potential utilization in the obstetric patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Mosier JM, et al. Extracorporeal membrane oxygenation (ECMO) for critically ill adults in the emergency department: history, current applications, and future directions. Crit Care. 2015;19:431.

    Article  Google Scholar 

  2. Pacheco LD, Saade GR, Hankins GDV. Extracorporeal membrane oxygenation (ECMO) during pregnancy and postpartum. Semin Perinatol. 2018;42(1):21–5.

    Article  Google Scholar 

  3. Makdisi G, Wang IW. Extra corporeal membrane oxygenation (ECMO) review of a lifesaving technology. J Thorac Dis. 2015;7(7):E166–76.

    PubMed  PubMed Central  Google Scholar 

  4. Peek GJ, et al. CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure. BMC Health Serv Res. 2006;6:163.

    Article  Google Scholar 

  5. Brogan TV, Lorusso R, MacLaren G, Peek G. Extracorporeal life support: the ELSO red book, vol. 5. 1st ed; 2017.

    Google Scholar 

  6. Lequier L, et al. Extracorporeal membrane oxygenation circuitry. Pediatr Crit Care Med. 2013;14(5 Suppl 1):S7–12.

    Article  Google Scholar 

  7. Van Meurs K, Peek G, Zwischenberger JB. ECMO extracorporeal cardiopulmonary support in critical care, vol. 290. Ann Arbor: Extracorporeal Life Support Organization; 2005.

    Google Scholar 

  8. Palanzo D, et al. Evolution of the extracorporeal life support circuitry. Artif Organs. 2010;34(11):869–73.

    Article  Google Scholar 

  9. Palanzo DA, et al. Choosing a pump for extracorporeal membrane oxygenation in the USA. Artif Organs. 2014;38(1):1–4.

    Article  Google Scholar 

  10. Donker DW, et al. Echocardiography in extracorporeal life support: a key player in procedural guidance, tailoring and monitoring. Perfusion. 2018;33(1_suppl):31–41.

    Article  Google Scholar 

  11. Doufle G, et al. Echocardiography for adult patients supported with extracorporeal membrane oxygenation. Crit Care. 2015;19:326.

    Article  Google Scholar 

  12. Kapoor PM. Echocardiography in extracorporeal membrane oxygenation. Ann Card Anaesth. 2017;20(Supplement):S1–3.

    PubMed  PubMed Central  Google Scholar 

  13. Peris A, et al. Clinical significance of echocardiography in patients supported by venous-venous extracorporeal membrane oxygenation. J Artif Organs. 2015;18(2):99–105.

    Article  CAS  Google Scholar 

  14. Platts DG, et al. The role of echocardiography in the management of patients supported by extracorporeal membrane oxygenation. J Am Soc Echocardiogr. 2012;25(2):131–41.

    Article  Google Scholar 

  15. Mehta N, et al. Respiratory disease in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2015;29(5):598–611.

    Article  Google Scholar 

  16. Duarte AG. ARDS in pregnancy. Clin Obstet Gynecol. 2014;57(4):862–70.

    Article  Google Scholar 

  17. Lapinsky SE. Acute respiratory failure in pregnancy. Obstet Med. 2015;8(3):126–32.

    Article  Google Scholar 

  18. Sultan AA, et al. Risk factors for first venous thromboembolism around pregnancy: a population-based cohort study from the United Kingdom. Blood. 2013;121(19):3953–61.

    Article  Google Scholar 

  19. Kearon C, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e419S–96S.

    Article  CAS  Google Scholar 

  20. Sharma NS, et al. Modern use of extracorporeal life support in pregnancy and postpartum. ASAIO J. 2015;61(1):110–4.

    Article  Google Scholar 

  21. Kikuchi J, Deering S. Cardiac arrest in pregnancy. Semin Perinatol. 2018;42(1):33–8.

    Article  Google Scholar 

  22. Hamdan R, et al. Peripartum cardiomyopathy, place of drug therapy, assist devices, and outcome after left ventricular assistance. J Crit Care. 2017;37:185–8.

    Article  Google Scholar 

  23. Moore SA, Dietl CA, Coleman DM. Extracorporeal life support during pregnancy. J Thorac Cardiovasc Surg. 2016;151(4):1154–60.

    Article  Google Scholar 

  24. Grasselli G, et al. Use of extracorporeal respiratory support during pregnancy: a case report and literature review. ASAIO J. 2012;58(3):281–4.

    Article  Google Scholar 

  25. Frenckner B, Broman M, Broome M. Position of draining venous cannula in extracorporeal membrane oxygenation for respiratory and respiratory/circulatory support in adult patients. Crit Care. 2018;22(1):163.

    Article  CAS  Google Scholar 

  26. Mulder MMG, Lance MD. ECMO and anticoagulation: a comprehensive review. Neth J Crit Care. 2018;26(1):6–13.

    Google Scholar 

  27. Gibson PS, Powrie R. Anticoagulants and pregnancy: when are they safe? Cleve Clin J Med. 2009;76(2):113–27.

    Article  Google Scholar 

  28. Bates SM, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy. Blood Adv. 2018;2(22):3317–59.

    Article  CAS  Google Scholar 

  29. Young SK, et al. Successful use of argatroban during the third trimester of pregnancy: case report and review of the literature. Pharmacotherapy. 2008;28(12):1531–6.

    Article  Google Scholar 

  30. Walton NKD. Anaesthesia for non-obstetric surgery during pregnancy. Contin Educ Anaesth Crit Care Pain. 2006;6:83–5.

    Article  Google Scholar 

  31. Neuman G. Safety of procedural sedation in pregnancy. J Obstet Gynaecol Can. 2013;35(2):168–73.

    Article  Google Scholar 

  32. Alshawabkeh L, Economy KE, Valente AM. Anticoagulation during pregnancy: evolving strategies with a focus on mechanical valves. J Am Coll Cardiol. 2016;68(16):1804–13.

    Article  Google Scholar 

  33. Saad AF, et al. Extracorporeal membrane oxygenation in pregnant and postpartum women with H1N1-related acute respiratory distress syndrome: a systematic review and meta-analysis. Obstet Gynecol. 2016;127(2):241–7.

    Article  CAS  Google Scholar 

  34. Abrams D, Bacchetta M, Brodie D. Recirculation in venovenous extracorporeal membrane oxygenation. ASAIO J. 2015;61(2):115–21.

    Article  CAS  Google Scholar 

  35. Alexis-Ruiz A, et al. Hypoxia and complications of oxygenation in extracorporeal membrane oxygenation. J Cardiothorac Vasc Anesth. 2019;33(5):1375–81.

    Article  Google Scholar 

  36. Montisci A, et al. Management of refractory hypoxemia during venovenous extracorporeal membrane oxygenation for ARDS. ASAIO J. 2015;61(3):227–36.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Nebraska Medical Center, Department of Anesthesiology, Division of Critical Care Medicine, Omaha, NE, USA

    Tal E. Sandler & Shaun L. Thompson

Authors
  1. Tal E. Sandler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shaun L. Thompson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shaun L. Thompson .

Editor information

Editors and Affiliations

  1. Critical Care Obstetrics Unit, Hospital Doctor Arnulfo Arias Madrid, Panama City, Panama

    Carlos Montufar

  2. Division of Critical Care, Karl Heusner Memorial Hospital, Belize City, Belize

    Jorge Hidalgo

  3. Houston Center for Maternal-Fetal Medicine, Houston, TX, USA

    Alfredo F. Gei

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sandler, T.E., Thompson, S.L. (2021). Extracorporeal Membrane Oxygenation in Pregnancy. In: Montufar, C., Hidalgo, J., Gei, A.F. (eds) Obstetric Catastrophes. Springer, Cham. https://doi.org/10.1007/978-3-030-70034-8_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-70034-8_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-70033-1

  • Online ISBN: 978-3-030-70034-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation