Extracorporeal Life Support in Pregnancy: A Systematic Review
Background The use of extracorporeal life support (ECLS) has expanded to include unique populations such as peripartum women. This systematic review aims to (1) quantify the number of cases and indications for ECLS in women during the peripartum period reported in the literature and (2) report mater...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.016072 |
| _version_ | 1818398652980264960 |
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| author | Emily E. Naoum Andrew Chalupka Jonathan Haft Mark MacEachern Cosmas J. M. Vandeven Sarah Rae Easter Michael Maile Brian T. Bateman Melissa E. Bauer |
| author_facet | Emily E. Naoum Andrew Chalupka Jonathan Haft Mark MacEachern Cosmas J. M. Vandeven Sarah Rae Easter Michael Maile Brian T. Bateman Melissa E. Bauer |
| author_sort | Emily E. Naoum |
| collection | DOAJ |
| description | Background The use of extracorporeal life support (ECLS) has expanded to include unique populations such as peripartum women. This systematic review aims to (1) quantify the number of cases and indications for ECLS in women during the peripartum period reported in the literature and (2) report maternal and fetal complications and outcomes associated with peripartum ECLS. Methods and Results This review was registered in PROSPERO (CRD42018108142). MEDLINE, Embase, and CINAHL were searched for case reports, case series, and studies reporting cases of ECLS during the peripartum period that reported one or more of the following outcomes: maternal survival, maternal complications, fetal survival, and/or fetal complications. Qualitative assessment of 221 publications evaluated the number of cases, clinical details, and maternal and fetal outcomes of ECLS during the peripartum period. There were 358 women included and 68 reported fetal outcomes in cases where the mother was pregnant at the time of cannulation. The aggregate maternal survival at 30 days was 270 (75.4%) and at 1 year was 266 (74.3%); fetal survival was 44 (64.7%). The most common indications for ECLS overall in pregnancy included acute respiratory distress syndrome 177 (49.4%), cardiac failure 67 (18.7%), and cardiac arrest 57 (15.9%). The most common maternal complications included mild to moderate bleeding 66 (18.4%), severe bleeding requiring surgical intervention 48 (13.4%), and intracranial neurologic morbidity 19 (5.3%). The most commonly reported fetal complications included preterm delivery 33 (48.5%) and neonatal intensive care unit admission 19 (27.9%). Conclusions Reported rates of survival in ECLS in pregnant and postpartum women are high and major complications relatively low. |
| first_indexed | 2024-12-14T07:08:12Z |
| format | Article |
| id | doaj.art-81eac64f26e64466b9a8007d6d178f5a |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-14T07:08:12Z |
| publishDate | 2020-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-81eac64f26e64466b9a8007d6d178f5a2022-12-21T23:12:04ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-07-0191310.1161/JAHA.119.016072Extracorporeal Life Support in Pregnancy: A Systematic ReviewEmily E. Naoum0Andrew Chalupka1Jonathan Haft2Mark MacEachern3Cosmas J. M. Vandeven4Sarah Rae Easter5Michael Maile6Brian T. Bateman7Melissa E. Bauer8Department of Anesthesiology University of Michigan Ann Arbor MIDepartment of Anesthesia, Critical Care and Pain Medicine Massachusetts General Hospital Boston MADepartment of Cardiac Surgery University of Michigan Ann Arbor MITaubman Health Sciences Library University of Michigan Ann Arbor MIDepartment of Obstetrics and Gynecology Maternal‐Fetal Medicine University of Michigan Ann Arbor MIDivision of Maternal‐Fetal Medicine Department of Obstetrics and Gynecology Brigham and Women’s Hospital Boston MADepartment of Anesthesiology University of Michigan Ann Arbor MIDivision of Pharmacoepidemiology and Pharmacoeconomics Department of Medicine Department of Anesthesiology, Perioperative and Pain Medicine Brigham and Women’s Hospital Boston MADepartment of Anesthesiology University of Michigan Ann Arbor MIBackground The use of extracorporeal life support (ECLS) has expanded to include unique populations such as peripartum women. This systematic review aims to (1) quantify the number of cases and indications for ECLS in women during the peripartum period reported in the literature and (2) report maternal and fetal complications and outcomes associated with peripartum ECLS. Methods and Results This review was registered in PROSPERO (CRD42018108142). MEDLINE, Embase, and CINAHL were searched for case reports, case series, and studies reporting cases of ECLS during the peripartum period that reported one or more of the following outcomes: maternal survival, maternal complications, fetal survival, and/or fetal complications. Qualitative assessment of 221 publications evaluated the number of cases, clinical details, and maternal and fetal outcomes of ECLS during the peripartum period. There were 358 women included and 68 reported fetal outcomes in cases where the mother was pregnant at the time of cannulation. The aggregate maternal survival at 30 days was 270 (75.4%) and at 1 year was 266 (74.3%); fetal survival was 44 (64.7%). The most common indications for ECLS overall in pregnancy included acute respiratory distress syndrome 177 (49.4%), cardiac failure 67 (18.7%), and cardiac arrest 57 (15.9%). The most common maternal complications included mild to moderate bleeding 66 (18.4%), severe bleeding requiring surgical intervention 48 (13.4%), and intracranial neurologic morbidity 19 (5.3%). The most commonly reported fetal complications included preterm delivery 33 (48.5%) and neonatal intensive care unit admission 19 (27.9%). Conclusions Reported rates of survival in ECLS in pregnant and postpartum women are high and major complications relatively low.https://www.ahajournals.org/doi/10.1161/JAHA.119.016072extracorporeal circulationextracorporeal membrane oxygenationpregnancy and postpartum |
| spellingShingle | Emily E. Naoum Andrew Chalupka Jonathan Haft Mark MacEachern Cosmas J. M. Vandeven Sarah Rae Easter Michael Maile Brian T. Bateman Melissa E. Bauer Extracorporeal Life Support in Pregnancy: A Systematic Review Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease extracorporeal circulation extracorporeal membrane oxygenation pregnancy and postpartum |
| title | Extracorporeal Life Support in Pregnancy: A Systematic Review |
| title_full | Extracorporeal Life Support in Pregnancy: A Systematic Review |
| title_fullStr | Extracorporeal Life Support in Pregnancy: A Systematic Review |
| title_full_unstemmed | Extracorporeal Life Support in Pregnancy: A Systematic Review |
| title_short | Extracorporeal Life Support in Pregnancy: A Systematic Review |
| title_sort | extracorporeal life support in pregnancy a systematic review |
| topic | extracorporeal circulation extracorporeal membrane oxygenation pregnancy and postpartum |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.016072 |
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