title: Extracorporeal membrane oxygenation saved a mother and her son from fulminant peripartum cardiomyopathy.
abstract: 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.
authors: Division of Cardiology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea.
authors: Sang Hyun
authors: SH
authors: Park
authors: Jung Yeon
authors: JY
authors: Chin
authors: Min Suk
authors: MS
authors: Choi
authors: Jin Ho
authors: JH
authors: Choi
authors: Yu Jeong
authors: YJ
authors: Choi
authors: Kyung Tae
authors: KT
authors: Jung
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000503:physiopathology / Q000628:therapy*; D002585:Cesarean Section; D003131:Combined Modality Therapy; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005316:Fetal Distress / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth; D008297:Male; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
keywords: cardiovascular; cesarean section; critical care obstetrics; post-partum care; post-partum hemorrhage