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4 . 2020

International and national experience of using extracorporeal membrane oxygenation in obstetrics

Abstract

Aim. There is insufficient information in the Literature on the use of extracorporeal membrane oxygenation (ECMO) in pregnant women. The objectives of the study were to analyze ECMO usage in pregnant patients, to establish clinical situations associated with ECMO use, and to assess survival rates accorded to nature of the pathology under consideration.

Material and methods. In the review data from retrospective cohort study on ECMO usage in the USA during the period from January 1, 1999 to October 1, 2015 were analyzed. Within the considered cohort, women who received ECMO were identified. Data on the use of extracorporeal membrane oxygenation in obstetric patients in the Russian Federation was also analyzed.

Results. The cohort of 15 335 205 births included 83 women treated with ECMO; thus the overall rate of ECMO usage was 0.54 per 100,000 pregnancies. The probability of ECMO use increased from 0.23/100,000 in 1999 to 2.57/100,000 in 2015. Patients who received ECMO were more likely to be older, had a low income and suffered from underlying diseases than patients who did not receive ECMO. The overall survival rate in the ECMO group was 62.7%. The most common reason for ECMO use was acute respiratory failure. The etiological factors associated with a higher survival rate among patients from the ECMO group included pneumonia and venous thromboembolism, in which the survival rate was 75.0% and 81.0%, respectively.

Conclusion. The frequency of ECMO use in obstetric population has increased over the past one and a half decade. Despite the fact that in the considered population ECMO usage has been associated with limited survival rates, the authors have proven its effectiveness when used as life-preserver in many patients with complications of pregnancy and childbirth.

Keywords:extracorporeal membrane oxygenation, maternal survival, pregnancy, postpartum period

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

Сontribution. Collection and processing of material - Ostrik K.A., Baranov I.I.; text writing - Ostrik K.A., Baranov I.I.; editing -Pyregov A.V., Baranov I.I.

For citation: Pyregov A.V., Baranov I.I., Ostrik K.A. International and national experience of using extracorporeal membrane oxygenation in obstetrics. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2020; 8 (4): 19-27. DOI: https://doi.org/10.24411/2303-9698-2020-14003 (in Russian)

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CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Department in the Russian People?s Friendship University

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