Stiff Alyssa, Harrison Rachel, Palatnik Anna
Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
J Obstet Gynaecol Res. 2019 Dec;45(12):2452-2455. doi: 10.1111/jog.14110. Epub 2019 Sep 4.
Hemoptysis in pregnancy is rare and can be life-threatening. This case describes management of hemoptysis in pregnancy requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO). The patient presented with massive hemoptysis in respiratory failure at 26 weeks gestation. VV-ECMO was utilized for maternal stability due to severe hypoxia from lung parenchymal damage. An extensive work-up for hemoptysis returned negative except for an elevated Bordetella pertussis IgG antibody. The patient was delivered via cesarean section with a complicated post-partum course. She and the infant were discharged in stable condition after long hospital stays. Prior publications describing VV-ECMO use in pregnancy are limited to treatment of respiratory infections such as influenza or pneumonia. This case is the first in the literature to describe VV-ECMO utilization for hemoptysis in pregnancy, specifically, and demonstrates its significant benefit in cases of respiratory failure due to hemoptysis.
孕期咯血较为罕见且可能危及生命。本病例描述了一名孕期咯血患者的治疗过程，该患者需要静脉-静脉体外膜肺氧合（VV-ECMO）支持。患者在妊娠26周时因呼吸衰竭出现大量咯血。由于肺实质损伤导致严重缺氧，VV-ECMO被用于维持母体稳定。除百日咳博德特氏菌IgG抗体升高外，针对咯血的全面检查结果均为阴性。患者通过剖宫产分娩，产后病程复杂。经过长时间住院治疗后，她和婴儿均康复出院。此前关于孕期使用VV-ECMO的文献报道仅限于治疗流感或肺炎等呼吸道感染。本病例是文献中首例专门描述孕期咯血使用VV-ECMO的案例，并证明了其在咯血导致呼吸衰竭病例中的显著益处。
