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Extracorporeal membrane oxygenation saved a mother and her son from fulminant peripartum cardiomyopathy
Author(s) -
Park Sang Hyun,
Chin Jung Yeon,
Choi Min Suk,
Choi Jin Ho,
Choi Yu Jeong,
Jung Kyung Tae
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12421
Subject(s) - medicine , peripartum cardiomyopathy , extracorporeal membrane oxygenation , cardiomyopathy , ejection fraction , ards , cardiology , heart failure , discontinuation , fulminant , pulmonary edema , anesthesia , lung
A 34‐year‐old full‐term pregnant woman presented with abruptly aggravating dyspnea. A chest X ‐ray showed pulmonary edema, and an echocardiogram revealed a left ventricular ejection fraction of 39%. Despite conventional medical treatment for acute heart failure and mechanical ventilation, hypoxia and metabolic acidosis were aggravated, and the fetal heart rate decreased to 90 b.p.m., suggestive of fetal distress. We decided to initiate extracorporeal membrane oxygenation ( ECMO ) and perform a cesarean section. The infant was successfully delivered without hypoxic brain damage. The patient was weaned from ECMO 6 days after delivery and was extubated 1 day after discontinuation of ECMO . Left ventricular systolic function had completely recovered at this time. This is the first report of a patient with peripartum cardiomyopathy who had a successful delivery with the support of ECMO , demonstrating that ECMO can serve as a rescue therapy, not only treating peripartum cardiomyopathy but also permitting a safe delivery.