Extracorporeal Membrane Oxygenation for Pulmonary Embolism During Pregnancy and Postpartum

Abstract

The maternal and fetal mortality rate in unstable pulmonary embolisms accompanied by obstructive cardiac shock is approximately 30%. An intervention aimed at the pulmonary clot is essential under these conditions. There are various ways of removing this clot from the pulmonary arteries, including thrombolytic administration, percutaneous catheter-based thrombectomy, and direct surgical clot removal. These procedures all have advantages and disadvantages. Increasing use is being made of extracorporeal membrane oxygenation (ECMO) as a means of reducing these risks to a minimum. There are studies recommending ECMO together with thrombolysis or surgical thrombectomy. However, which study is superior to another is unclear. The purpose of the present study was, therefore, to assess the benefits and risks of ECMO use in pregnant patients with pulmonary embolism and to endeavor to produce a new algorithm.

Pulmonary Embolism in Pregnancy: A Review for Clinical Practitioners

“…There are studies that recommend ECMO with thrombolysis or surgical thrombectomy. However, it is unclear which trial is superior to another [108] in the general population, even in pregnant women (there are no known studies in this group).…”