ECMO in pregnant and postpartum women – a lifesaving procedure

Author Name: Ms. Siji Varghese¹, Riya Vaghela², Suchanda Devi³, Thakor Pritesh⁴

Volume: 03/01

Country: India

DOI NO.: 11.2023-61555522 DOI Link: https://doi-ds.org/doilink/05.2025-61413534/GIJNR

Affiliation:

1. Clinical Instructor, Parul Institute of Nursing, Parul University, Vadodara, Gujarat, India
2. Post Basic B.Sc. Nursing Students, Parul institute of Nursing, Parul university, Vadodara, Gujarat, India
3. Post Basic B.Sc. Nursing Students, Parul institute of Nursing, Parul university, Vadodara, Gujarat, India
4. Post Basic B.Sc. Nursing Students, Parul institute of Nursing, Parul university, Vadodara, Gujarat, India

ABSTRACT

Extracorporeal Membrane Oxygenation (ECMO) is an advanced life-support technique that provides temporary cardiac and respiratory support to patients with severe cardiopulmonary failure. Its use in pregnant and postpartum women is growing, particularly in cases where conventional therapies fail to stabilize the maternal condition. Conditions such as acute respiratory distress syndrome (ARDS), peripartum cardiomyopathy, pulmonary embolism, and amniotic fluid embolism can lead to life-threatening complications during pregnancy and the postpartum period. In such scenarios, ECMO offers a critical bridge to recovery or definitive treatment, improving maternal survival rates significantly. Despite the inherent risks to both mother and fetus, including hemorrhage, thrombosis, and preterm birth, studies report maternal survival rates between 77% to 90%, and fetal survival rates ranging from 65% to 83%. Managing ECMO in obstetric patients requires careful consideration of physiological changes in pregnancy, ethical concerns, and multidisciplinary collaboration among obstetricians, intensivists, neonatologists, and cardiologists. Timely initiation and individualized care protocols are key to optimizing outcomes. This review compiles current evidence on ECMO application in obstetrics, emphasizing its indications, outcomes, complications, and clinical considerations. It underlines the need for continued research and standardized guidelines to ensure safe and effective ECMO use in maternal critical care settings.

Key words: ECMO, Pregnancy, Postpartum, Cardiopulmonary failure, Multidisciplinary care, Maternal outcomes.