The first case of Cesarean section in a pregnant woman during extracorporeal membrane oxygenation (ECMO) in Russia

Abstract

A 22-year-old pregnant woman (34.6 weeks of pregnancy) with A(H1N1) influenza-associated acute respiratory distress syndrome was admitted to the intensive care unit. Results. The patient was connected to femoral-jugular veno-venous extracorporeal membrane oxygenation (ECMO) 2 hours after admission. On the 2nd day of ECMO support, in connection with the beginning of labor activity and a threat to the life of the mother and fetus, the decision was made on the implementation of caesarean section (CS) without the termination of ECMO. CS was performed under general anesthesia, 2 hours after discontinuation of heparin infusion. Were extracted a premature baby girl, weighing 2380 g. Intraoperative period was complicated by atonic uterine bleeding, requiring a hysterectomy. On the 16th day the patient was successfully weaned from ECMO and was discharged after 11 days. The newborn was discharged from the clinic in a satisfactory condition after 24 days with a weight of 2860 g. Conclusion. This is the first case in Russia of successful use of ECMO and emergency cesarean section (CS) during ECMO in a pregnant woman with acute respiratory distress syndrome (ARDS) due to complications of influenza A(H1N1).