Extra corporeal membrane oxygenation (ECMO) in pregnant and postpartum women

Abstract

Key points Extra corporeal membrane oxygenation (ECMO) is an advanced life support technique used in cases of respiratory and cardiovascular failure when conventional intensive care supportive therapies have been exhausted. ECMO has been used to support pregnant and postpartum women and people presenting with several cardiac and respiratory pathologies; it has gained wider recognition among the obstetric community owing to the COVID‐19 pandemic. It is important for clinicians to understand the difference between veno‐venous and veno‐arterial ECMO and the different purposes of these configurations. It is important to consider such dilemmas in the provision of care as when to deliver and monitoring the fetus. Management of pregnant women on ECMO is complex and requires MDT discussions, repeated regularly when the clinical situation, including when gestation crosses stages of viability, changes. Learning objectives To learn about the different types, aim and risks of ECMO. To understand the benefit and risks of delivery of the fetus. To be aware of the management of critically ill antenatal and post‐partum patients being considered for ECMO or whilst receiving ECMO support.