CASE HISTORY – January 2023

Extracorporeal membrane oxygenation in pregnant patients with COVID-19 pneumonia – a literature review and two case reports

Authors: Oskar Appelberg, Martin Padar, Olavi Maasikas

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The use of extracorporeal membrane oxygenation (ECMO) in pregnancy and post-partum is well described. Indications for ECMO in pregnancy are equally divided between cardiac and respiratory failure, while in the post-partum period, cardiac indications are more frequent. Maternal survival is high (>70%) and has been increasing over the last decades. The use of ECMO in pregnant and postpartum patients compared to non-obstretric controls seems to be associated with a similar incidence of complications and higher hospital survival rates.

Our case reports describe the use of ECMO in critically ill pregnant patients with severe lung injury due to COVID-19 pneumonia. In both cases, the lives of both mothers and children were saved and good quality of life was preserved. An important aspect in caring for similar patients is vigilance in detecting and treating complications which may arise both due to the disease, but also in relation to applied treatments. Multidisciplinary discussion is essential in both guiding care and planning for possible complications.