Labour induction during ECMO support of a pregnant woman with severe respiratory distress syndrome caused by influenza

liu chunli¹， Sun Wenqing¹， Zhou Mingxiang¹， Sun Ying¹， Wang Chunting¹

1.Shandong Provincial Chest Hospital
2.Provincial Hospital affiliated to Shandong University

目的: To observe the effect of labour induction during ECMO support in a pregnant woman with ARDS caused by influenza

方法: Here, we reported a case of labour induction during ECMO support of a pregnant woman with ARDS. Infection with the influenza A (H1N1) virus was confirmed by polymerase chain reaction assays. On day 2 of ECMO, the foetus died. The patient received misoprostol (50 μg) once and mifepristone (100 mg/day) orally for two days. On day 5 of ECMO support, the gynaecologist placed misoprostol (100 μg) in the posterior vaginal fornix. Three hours later the dead foetus was completely delivered.

结果:

On the day after delivery, ECMO was successfully discontinued. After seven more days, the patient was weaned from mechanical ventilation. After labour induction, lung compliance and oxygenation improved. However, the ECMO blood flow was unstable and decreased as uterine contractions strengthened.

结论:

The findings showed that labour induction may be beneficial to improve oxygenation and reduce the duration of ECMO. We recommended that procedure should be performed by an experienced ECMO team, cooperating with the obstetrician, anaesthesiologist and ICU doctors.