Extra-corporeal membrane oxygenation and emergency C-section for a pregnant COVID-19 positive patient

Perfusion. 2023 Mar;38(2):405-409. doi: 10.1177/02676591211049769. Epub 2021 Oct 7.

Abstract

Introduction: Data on extra-corporeal membrane oxygenation (ECMO) therapy for pregnant patients with Coronavirus 2019 (COVID-19) infection are limited. Here we report a case of an emergency cesarean section performed while the COVID-19 positive mother was on ECMO support.

Case report: A 36-year-old COVID-19 positive patient at 26 weeks gestational age presented with respiratory failure requiring extra-corporeal membrane oxygenation therapy. Nine days later fetal distress demanded an emergency C-section. After 5 weeks on ECMO, the patient was weaned off. Both mother and child were discharged.

Discussion: The decision to perform an urgent C-section is one that requires meticulous thought from the attending team. Pulmonary maturation is key as pregnancy may need to be terminated at any time during ECMO.

Conclusion: Data on ECMO support for pregnant patients with COVID-19 infection are scarce. Best results can be achieved ensuring adequate anticoagulation, meticulous choice of cannulas, continued fetal monitoring, early lung maturation, and precision timing of delivery.

Keywords: COVID-19; extra-corporeal membrane oxygenation; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • COVID-19* / therapy
  • Cesarean Section
  • Child
  • Extracorporeal Membrane Oxygenation* / methods
  • Female
  • Humans
  • Lung
  • Pregnancy
  • Respiratory Insufficiency*