Advertisement

Extracorporeal membrane oxygenation in pregnancy: a bridge to delivery and pulmonary recovery for COVID-19–related severe respiratory failure

Published:January 19, 2022DOI:https://doi.org/10.1016/j.ajog.2022.01.008
      To the Editors:
      The study by Yin et al
      • Yin O.
      • Richley M.
      • Hadaya J.
      • et al.
      Extracorporeal membrane oxygenation in pregnancy: a bridge to delivery and pulmonary recovery for COVID-19-related severe respiratory failure.
      entitled, “Extracorporeal membrane oxygenation (ECMO) in pregnancy: a bridge to delivery and pulmonary recovery for COVID-19-related severe respiratory failure,” has been a milestone in the road to maternofetal management of severe COVID-19. Pregnancy prolongation with the aid of ECMO could successfully serve as a bridge to maternal respiratory recovery. We wish to put forth certain queries to comprehend the results better. We learned that 3 of 5 women were given convalescent plasma and that 2 of 5 women were administered tocilizumab. It would be helpful if the authors could tell us about their criteria for starting the aforementioned therapeutic regimes and which patients received them.
      It will be a great favor if the authors could mention the fourth patient in a bit more detail. We noticed that she suffered a cardiac arrest while on ECMO. How many days of ECMO did she have before she experienced cardiac arrest and how was she revived? Moreover, we are quite interested to learn about patient 3 who developed hemolysis, elevated liver enzymes, and low platelet count while on ECMO despite being normotensive initially. On the contrary, patient 1, who was preeclamptic, did not develop such hypertensive complications.
      Most mothers had developed postpartum mood disorders, which was quite obvious after prolonged stress. Did they require pharmacotherapy or could they be managed with psychosocial counseling? We recommend that the authors make a long-term follow-up of both the mothers and their infants and report their long-term health status in subsequent studies.

      Reference

        • Yin O.
        • Richley M.
        • Hadaya J.
        • et al.
        Extracorporeal membrane oxygenation in pregnancy: a bridge to delivery and pulmonary recovery for COVID-19-related severe respiratory failure.
        Am J Obstet Gynecol. 2022; 226: 571-576.e5

      Linked Article