Successful use of Extracorporeal Membrane Oxygenation (ECMO) in postpartum as rescue therapy in a woman with Covid-19: ECMO postpartum in COVID-19 patient

Fiore, Antonio; Piscitelli, Mariantonietta; Adodo, Didier K.; Thomas, Charrier; Dessap, Armand Mekontso; Bagate, François; Folliguet, Thierry

Clinical manifestations of coronavirus disease 2019 (COVID-19) in pregnant women, in contrast to last outbreaks, seem to be similar to those of non-pregnant women. During severe acute respiratory syndrome (SARS), SARS influenza A (H1N1), and Middle East respiratory syndrome (MERS) outbreaks an increased severity of disease among pregnant women was observed. In some pregnant women, respiratory failure can occur and quickly progress to acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) as a rescue therapy. Despite a lack of current guidelines on the use of ECMO in pregnant or postpartum women, this support therapy is an effective salvage therapy for patients with cardiac and/or respiratory failure, and is associated with favorable maternal and fetal outcomes. Herein, we report a case of severe COVID-19 disease in a pregnant patient after urgent cesarean section, who was successfully treated with ECMO during the postpartum. ECMO should be considered early when conventional therapy is ineffective and it is essential to refer to ECMO expert centers.