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流感所致严重呼吸窘迫综合征孕妇在体外膜肺氧合(ECMO)支持下分娩:一例病例报告及文献复习

Delivery during extracorporeal membrane oxygenation (ECMO) support of pregnant woman with severe respiratory distress syndrome caused by influenza: a case report and review of the literature.

作者信息

Liu Chunli, Sun Wenqing, Wang Chunting, Liu Fenglin, Zhou Mingxiang

机构信息

a Shandong Provincial Hospital affiliated to Shandong University , Jinan , China.

b Shandong Provincial Chest Hospital , Jinan , China.

出版信息

J Matern Fetal Neonatal Med. 2019 Aug;32(15):2570-2574. doi: 10.1080/14767058.2018.1439471. Epub 2018 Feb 22.

Abstract

OBJECTIVE

To report a case of labour induction during extracorporeal membrane oxygenation (ECMO) support in a patient with acute respiratory distress syndrome (ARDS) caused by influenza and review of the literature.

METHODS

Case report and the literature search of all English articles on delivery while on ECMO in patients with ARDS caused by influenza.

RESULTS

A 25-year-old pregnant woman was initiated with ECMO due to severe ARDS caused by influenza A (H1N1) virus. When the patient had symptoms of colporrhagia and uterine contractions, the medical team decided to start labour induction while on ECMO. There were in total five case reports identified. Maternal oxygenation was improved after delivery and ECMO was successfully discontinued.

CONCLUSIONS

Maternal oxygenation was improved after delivery, which may be beneficial to reduce the duration of ECMO. Caesarean section (CS) may be the most used mode and labour induction could be another option. The procedure should be performed by an experienced ECMO team, cooperating with the obstetrician, anaesthesiologist, and ICU doctors.

摘要

目的

报告1例体外膜肺氧合(ECMO)支持下流感所致急性呼吸窘迫综合征(ARDS)患者引产的病例并进行文献复习。

方法

病例报告及检索所有关于流感所致ARDS患者在ECMO支持下分娩的英文文章。

结果

一名25岁孕妇因甲型H1N1流感病毒导致的严重ARDS启动了ECMO。当患者出现阴道出血和子宫收缩症状时,医疗团队决定在ECMO支持下开始引产。共确定了5例病例报告。分娩后母体氧合得到改善,ECMO成功撤机。

结论

分娩后母体氧合得到改善,这可能有利于缩短ECMO的使用时间。剖宫产(CS)可能是最常用的方式,引产也可以是另一种选择。该操作应由经验丰富的ECMO团队与产科医生、麻醉医生和重症监护病房医生合作进行。

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