Extracorporeal membrane oxygenation therapy for circulatory arrest due to postpartum hemorrhage.
BACKGROUND
Cardiac arrest after postpartum hemorrhage may not respond to advanced life support. Various resuscitation methods have been proposed, including sternotomy and direct cardiac massage. Extracorporeal membrane oxygenation (ECMO) might be an alternative.


METHODS
We report the case of a woman who suffered atonic uterine hemorrhage perioperatively after cesarean delivery of twins. During initial conservative treatment using prostaglandin analog (sulprostone), cardiac decompensation developed and was followed by cardiopulmonary arrest. Circulatory failure remained unresponsive after 2 hours of resuscitation, when ECMO was initiated. The ensuing recovery was favorable.


CONCLUSIONS
Aggressive mechanical circulatory support, such as ECMO, should be considered in a case of potentially reversible cardiocirculatory failure in a young obstetric patient.
Reyftmann
Lionel
L
Department of Obstetrics and Gynecology, A. de Villeneuve University Hospital, France. l-reyftmann@chu-montpellier.fr
Morau
Estelle
E
Dechaud
Herve
H
Herve
Dechaud
D
Frapier
Jean-Marc
JM
Jean-Marc
Frapier
F
Hedon
Bernard
B
Bernard
Hedon
H
D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D006473:Postpartum Hemorrhage; D011247:Pregnancy