{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T20:39:22Z","timestamp":1777581562302,"version":"3.51.4"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The leading causes of maternal mortality include respiratory failure, cardiovascular events, infections, and hemorrhages. The use of extracorporeal membrane oxygenation (ECMO) as rescue therapy in the peripartum period for cardiopulmonary failure is expanding in critical care medicine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective observational study was conducted on a nationwide cohort in Israel. During the 3\u2010year period, between September 1, 2019, and August 31, 2022, all women in the peripartum period who had been supported by ECMO for respiratory or circulatory failure at 10 large Israeli hospitals were identified. Indications for ECMO, maternal and neonatal outcomes, details of ECMO support, and complications were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the 3\u2010year study period, in Israel, there were 540\u2009234 live births, and 28 obstetric patients were supported by ECMO, with an incidence of 5.2 cases per 100\u2009000 or 1 case per 19\u2009000 births (when excluding patients with COVID\u201019, the incidence will be 2.5 cases per 100\u2009000 births). Of these, 25 were during the postpartum period, of which 16 (64%) were connected in the PPD1, and 3 were during pregnancy. Eighteen patients (64.3%) were supported by V\u2010V ECMO, 9 (32.1%) by V\u2010A ECMO, and one (3.6%) by a VV\u2010A configuration. Hypoxic respiratory failure (ARDS) was the most common indication for ECMO, observed in 21 patients (75%). COVID\u201019 was the cause of ARDS in 15 (53.7%) patients. The indications for the V\u2010A configuration were cardiomyopathy (3 patients), amniotic fluid embolism (2 patients), sepsis, and pulmonary hypertension. The maternal and fetal survival rates were 89.3% (<jats:italic>n<\/jats:italic>\u2009=\u200925) and 100% (<jats:italic>n<\/jats:italic>\u2009=\u200928). The average ECMO duration was 17.6\u2009\u00b1\u200918.6\u2009days and the ICU stay was 29.8\u2009\u00b1\u200923.8\u2009days. Major bleeding complications requiring surgical intervention were observed in one patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of using ECMO in the peripartum period is low. The maternal and neonatal survival rates in patients treated with ECMO are high. These results show that ECMO remains an important treatment option for obstetric patients with respiratory and\/or cardiopulmonary failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14691","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T11:12:28Z","timestamp":1702984348000},"page":"392-401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Extracorporeal membrane oxygenation in obstetric patients: An Israeli nationwide study"],"prefix":"10.1111","volume":"48","author":[{"given":"Dana","family":"Yahav\u2010Shafir","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Sheba Medical Centre  Tel Hashomer Israel"},{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduard","family":"Ilgiyaev","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Department of General Intensive Care Shamir Medical Center  Zerifin Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ori","family":"Galante","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Soroka University Medical Centre  Beer\u2010Sheva Israel"},{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Gorfil","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Cardiothoracic Surgery, Cardiothoracic Intensive Care Unit Rabin Medical Center\u2010Beilinson Hospital  Petah Tikva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liran","family":"Statlender","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"General Intensive Care Unit Rabin Medical Center\u2010Beilinson Hospital  Petah Tikva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arie","family":"Soroksky","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Intensive Care Unit Wolfson Medical Centre  Holon Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uri","family":"Carmi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Division of Anesthesia, Pain and Intensive Care Tel Aviv Sourasky Medical Center  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yitzhak Brzezinski","family":"Sinai","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Division of Anesthesia, Pain and Intensive Care Tel Aviv Sourasky Medical Center  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nisim","family":"Iprach","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Anesthesia and Intensive Care Meir Medical Center  Kfar\u2010Saba Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael","family":"Haviv\u2010Yadid","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Intensive Care Unit Sheba Medical Center  Tel Hashomer Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4487-1153","authenticated-orcid":false,"given":"Maged","family":"Makhoul","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Rambam Medical Center  Haifa Israel"},{"name":"The Ruth &amp; Bruce Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Fatnic","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Hadassah Hebrew University, Ein Karem Medical Center  Jerusalem Israel"},{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yehuda","family":"Ginosar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"},{"name":"Department of Anesthesiology, Mother &amp; Child Anesthesia Unit Hadassah Hebrew University, Ein Karem Medical Center  Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Einav","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"},{"name":"General Intensive Care Unit Shaare Zedek Medical Center  Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yigal","family":"Helviz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"},{"name":"General Intensive Care Unit Shaare Zedek Medical Center  Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Fink","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Hebrew University of Jerusalem  Jerusalem Israel"},{"name":"Department of Cardiothoracic Surgery Shaare Zedek Medical Center  Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonid","family":"Sternik","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Cardiac Surgery Sheba Medical Centre  Tel Hashomer Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8312-3433","authenticated-orcid":false,"given":"Alexander","family":"Kogan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Cardiac Surgery Sheba Medical Centre  Tel Hashomer Israel"},{"name":"Cardiac Surgery Intensive Care Unit Sheba Medical Centre  Tel Hashomer Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)31470\u20102"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6818e1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.016072"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005861"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.14261"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201710\u20102130CP"},{"key":"e_1_2_8_8_1","unstructured":"https:\/\/www.merckmanuals.com\/. 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