ECMO in Peripartum Period: Lifesaving Therapeutic Intervention

ECMO is a form of life support that can be used in the peripartum period; it involves the use of an external (outside of the body) oxygenator to oxygenate the blood. It is typically used as a last resort for patients with severe respiratory or cardiovascular failure. ECMO can be classified into two main types: veno-arterial (VA) ECMO and veno-venous. VA ECMO is used to support the function of both the heart and the lungs whereas (VV) ECMO mainly supports the lung function. It is important that healthcare providers have a clear understanding of the indications, benefits, and risks of ECMO in this setting to ensure that it is used effectively and safely. Indications for ECMO can be divided into four categories: hypoxemic respiratory failure, hypercapnic respiratory failure, cardiogenic shock, and cardiac arrest. It is crucial to remember that ECMO in pregnant patients is typically only used as a last resort because of the hazards involved, which include bleeding, infection, and blood vessel damage. The decision to use ECMO in pregnant women should be made on a case-by-case basis, considering the potential risks and benefits of the procedure. The survival rate does not appear to be affected by the indication or type of ECMO (VV or VA). The timing of ECMO assistance is crucial, and outcomes may be linked to its early use, in pregnant patients. It is important to prevent maternal hypoxia, hypercarbia, and acidosis. Referral to a specialist ECMO center with a dedicated ECMO team should be considered.