ArticleCritical care (London, England)2022
Amniotic fluid embolism rescued by venoarterial extracorporeal membrane oxygenation.
Article in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Extracorporeal membrane oxygenation in obstetrical patients: a meta-analysis.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Pooled it
- Spontaneous amniotic fluid embolism associated with a large subchorionic hematoma in the second trimester: a case report.BMC pregnancy and childbirth · 2026Article
- Management of Amniotic Fluid Embolism (AFE) using anticoagulation-free ECMO.Zeitschrift fur Geburtshilfe und Neonatologie · 2026Article
- Successful management of amniotic fluid embolism with cardiac arrest and liver rupture: a case report.Frontiers in medicine · 2026Article
- Analysis of immune-related biomarkers in amniotic fluid embolism by sequencing data and bioinformatics.BMC pregnancy and childbirth · 2025Article
- Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support.Resuscitation plus · 2025Article
- Risk factors and predisposing conditions for amniotic fluid embolism: a comprehensive review.Journal of medicine and life · 2025Review
- Anticoagulation and associated complications in veno-arterial extracorporeal membrane oxygenation in adult patients: A systematic review and meta-analysis.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024Review
- Article
- Post-abortion Complications: A Narrative Review for Emergency Clinicians.The western journal of emergency medicine · 2022Review
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAmniotic fluid embolism (AFE) is a rare but often catastrophic complication of pregnancy that leads to cardiopulmonary dysfunction and severe disseminated intravascular coagulopathy (DIC). Although few case reports have reported successful use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) with AFE, concerns can be raised about the increased bleeding risks with that device.
methodsThis study included patients with AFE rescued by VA-ECMO hospitalized in two high ECMO volume centers between August 2008 and February 2021. Clinical characteristics, critical care management, in-intensive care unit (ICU) complications, and hospital outcomes were collected. ICU survivors were assessed for health-related quality of life (HRQL) in May 2021.
resultsDuring that 13-year study period, VA-ECMO was initiated in 54 parturient women in two high ECMO volume centers. Among that population, 10 patients with AFE [median (range) age 33 (24-40), SAPS II at 69 (56-81)] who fulfilled our diagnosis criteria were treated with VA-ECMO. Pregnancy evolved for 36 (30-41) weeks. Seven patients had a cardiac arrest before ECMO and two were cannulated under cardiopulmonary resuscitation. Pre-ECMO hemodynamic was severely impaired with an inotrope score at 370 (55-1530) μg/kg/min, a severe left ventricular ejection fraction measured at 14 (0-40)%, and lactate at 12 (2-30) mmol/L. 70% of these patients were alive at hospital discharge despite an extreme pre-ECMO severity and massive blood product transfusion. However, HRQL was lower than age-matched controls and still profoundly impaired in the role-physical, bodily pain, and general health components after a median of 44 months follow-up.
conclusionIn this rare per-delivery complication, our results support the use of VA-ECMO despite intense DIC and ongoing bleeding. Future studies should focus on customized, patient-centered, rehabilitation programs that could lead to improved HRQL in this population.
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