Extracorporeal cardiopulmonary resuscitation in a woman with twin pregnancy

• Published in: Perfusion Vol. 37; no. 4; p. 422
• Main Authors: Tantibundit, Porntipa, Mekjarasnapha, Manasicha, Pulnitiporn, Aksorn, Jirasavetakul, Adhus
• Format: Journal Article
• Language: English
• Published: England 01.05.2022
• Subjects: Adult; Cardiopulmonary Resuscitation; Extracorporeal Membrane Oxygenation; Female; Heart Arrest - etiology; Heart Arrest - therapy; Humans; Pregnancy; Pregnancy, Twin; Prospective Studies; Retrospective Studies; Young Adult; ECMO; ECPR; emergency hysterectomy; perimortem cesarean delivery; pregnancy; extracorporeal cardiopulmonary resuscitation; cardiac arrest
• DOI: 10.1177/02676591211003281

Maternal cardiac arrest is a rare condition. Cardiopulmonary resuscitation (CPR) in pregnancy is different from that in other populations due to physiological changes in patients. Extracorporeal cardiopulmonary resuscitation (ECPR) is recommended in patients having cardiac arrest with potentially reversible etiologies. However, data regarding ECPR in pregnancy are limited. A 24-year-old woman with a 33-week twin pregnancy developed witnessed cardiac arrest in an antenatal clinic. She underwent perimortem cesarean delivery (PMCD) and ECPR, but uterine atony with massive bleeding occurred. Emergency hysterectomy and massive blood transfusion were performed in the emergency department and the patient was transferred to the intensive care unit after hemodynamics was stable. Cardiac arrest in pregnancy is a complex condition. Several aspects of management have not been evaluated. Prospective studies for improving the outcomes are needed.