Key result
Delivery during ECMO support in pregnant women with severe influenza-induced ARDS improved maternal oxygenation and allowed successful discontinuation of ECMO.
Why the study?
Does delivery improve maternal oxygenation and facilitate ECMO discontinuation in pregnant women with severe ARDS on ECMO?
Case Report (n=6)
Does delivery improve maternal oxygenation and facilitate ECMO discontinuation in pregnant women with severe ARDS on ECMO?
Delivery during ECMO support for severe ARDS in pregnancy may improve maternal oxygenation and facilitate successful weaning from ECMO.
Labor induction on ECMO for influenza ARDS may be feasible in select cases; leaves open need for prospective outcome data.
OBJECTIVE: To report a case of labour induction during extracorporeal membrane oxygenation (ECMO) support in a patient with acute respiratory distress syndrome (ARDS) caused by influenza and review of the literature. METHODS: Case report and the literature search of all English articles on delivery while on ECMO in patients with ARDS caused by influenza. RESULTS: A 25-year-old pregnant woman was initiated with ECMO due to severe ARDS caused by influenza A (H1N1) virus. When the patient had symptoms of colporrhagia and uterine contractions, the medical team decided to start labour induction while on ECMO. There were in total five case reports identified. Maternal oxygenation was improved after delivery and ECMO was successfully discontinued. CONCLUSIONS: Maternal oxygenation was improved after delivery, which may be beneficial to reduce the duration of ECMO. Caesarean section (CS) may be the most used mode and labour induction could be another option. The procedure should be performed by an experienced ECMO team, cooperating with the obstetrician, anaesthesiologist, and ICU doctors.
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Liu et al. (2018) conducted a case report in Severe acute respiratory distress syndrome (ARDS) caused by influenza in pregnancy (n=6). Delivery (labour induction or Caesarean section) during ECMO support was evaluated on Maternal oxygenation and ECMO discontinuation. Delivery during ECMO support in pregnant women with severe influenza-induced ARDS improved maternal oxygenation and allowed successful discontinuation of ECMO.
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