Extracorporeal membrane oxygenation in pregnant and postpartum women with H1N1-related acute respiratory distress syndrome

Saad, Antonio F., Rahman, Mahbubur, Maybauer, Dirk M., Fraser, John F., Costantine, Maged M., Pacheco, Luis D. and Maybauer, Marc O. (2016) Extracorporeal membrane oxygenation in pregnant and postpartum women with H1N1-related acute respiratory distress syndrome. Obstetrics and Gynecology, 127 2: 241-247. doi:10.1097/AOG.0000000000001236


Author Saad, Antonio F.
Rahman, Mahbubur
Maybauer, Dirk M.
Fraser, John F.
Costantine, Maged M.
Pacheco, Luis D.
Maybauer, Marc O.
Title Extracorporeal membrane oxygenation in pregnant and postpartum women with H1N1-related acute respiratory distress syndrome
Journal name Obstetrics and Gynecology   Check publisher's open access policy
ISSN 1873-233X
0029-7844
Publication date 2016-02-01
Year available 2016
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/AOG.0000000000001236
Open Access Status Not Open Access
Volume 127
Issue 2
Start page 241
End page 247
Total pages 7
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2017
Language eng
Formatted abstract
Objective: To assess available evidence regarding the use of extracorporeal membrane oxygenation (ECMO) in pregnant and postpartum women with acute respiratory distress syndrome (ARDS) secondary to H1N1 infection.

Data Sources: Databases from MEDLINE (U.S. National Library of Medicine, 1946 to April 1, 2015), the Cochrane Library Controlled Trials Register, ClinicalTrials.gov, and Web of Science were queried for studies on ECMO in pregnant or postpartum patients with ARDS. Search terms included: "ARDS," "ECMO," "pregnant," and "postpartum."

Tabulation, integration, and results: All relevant references in any language were reviewed. Literature for inclusion and methodologic quality were reviewed based on the meta-analyses and systematic reviews of observational studies (Meta-analysis Of Observational Studies in Epidemiology) guidelines. Of 266 citations, five retrospective studies (39 patients) fulfilled our inclusion criteria. No randomized controlled trials were found. The pooled estimate of the survival rate among pregnant and postpartum patients who received ECMO for ARDS secondary to H1N1 was 74.6% (95% confidence interval [CI] 60.7-88.6%). Neonatal outcomes were reported in two studies and the rate of live birth was 70% (95% CI 43.7-95.2). Heterogeneity was not significant among studies (I 2 ranged from 0% to 21%; P>.25).

Conclusion: The role of ECMO in pregnant and postpartum women with ARDS from H1N1 remains unclear and the benefits suggested from our review should be interpreted with caution. © 2016 by The American College of Obstetricians and Gynecologists.
Keyword Acute respiratory failure
Adult respiratory distress syndrome
Pregnant women
Extracorporeal oxygenation
H1N1
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
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