Application of extracorporeal membrane oxygenation in critical obstetric conditions
10.3760/cma.j.cn431274-20250730-01014
- VernacularTitle:ECMO在产科危重症中的应用
- Author:
Yiran PENG
1
;
Ni AN
;
Xinke MENG
;
Quanfu ZHANG
;
Mei ZHONG
Author Information
1. 香港中文大学妇女儿童医学中心(深圳)妇产科，深圳 518100
- Publication Type:Journal Article
- Keywords:
Extracorporeal membrane oxygenation;
Obstetric critical illness
- From:
Journal of Chinese Physician
2025;27(9):1288-1293
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically review recent domestic and international literature on the use of extracorporeal membrane oxygenation (ECMO) in obstetric critical care and provide evidence-based support for clinical decision-making.Methods:Literature published between January 1, 2014, and December 31, 2024, in both Chinese and English was retrieved from databases including CNKI, Wanfang Medical Network, Chinese Medical Journal Network, PubMed, and Embase. Data on maternal age, gestational age, diagnosis, ECMO type, ECMO duration, pregnancy outcomes, and maternal and neonatal survival rates were extracted from relevant studies.Results:Among 1 306 retrieved articles, 214 met the inclusion criteria, involving a total of 355 obstetric patients who received ECMO treatment. The majority of patients (58.9%, 209/355) were treated postpartum. The most common indications for ECMO initiation included pulmonary infection (32.7%, 116/355), pulmonary embolism (24.5%, 87/355), pulmonary hypertension (12.4%, 44/355), sepsis (9.6%, 34/355), and peripartum cardiomyopathy (6.2%, 22/355). The modes of ECMO used in the obstetric population were venovenous (VV) in 49.6%(176/355) and venoarterial (VA) in 44.2%(157/355) of cases. The overall maternal survival rate was 82.0%(291/355), while the fetal/neonatal survival rate was 74.4%(264/355). Bleeding was the most common complication (35.5%, 126/355), followed by thrombosis (14.6%, 52/355) and infections related to ventilator or cannulation sites (19.2%, 68/355).Conclusions:ECMO can serve as an effective temporary organ support therapy for critically ill patients during pregnancy and the postpartum period.
