The role of ECMO in acute intrapartum or postpartum events during cesarean section: A scoping review
Bibliographic record
Abstract
Background Peripartum obstetric emergencies, such as amniotic fluid embolism, massive haemorrhage or peripartum cardiomyopathy, can result in hemodynamic collapse and multi-organ failure. Extracorporeal membrane oxygenation (ECMO) offers temporary cardiopulmonary support by facilitating gas exchange and circulatory support in above situations. This review aims to evaluate the role and outcomes of ECMO use during acute intrapartum or early postpartum hemodynamic instability in patients undergoing Caesarean section. Methods A comprehensive literature search was conducted using PubMed, Embase, Medline, and Cochrane Central databases to identify relevant studies published up to January 2025. Inclusion criteria encompassed case reports and case series describing the use of ECMO in obstetric patients experiencing hemodynamic collapse during or within 24 hours of Caesarean section. Exclusion criteria included non-obstetric patients, ECMO initiated beyond the early postpartum period, and studies without outcome data. A total of 18 publications reporting on 20 individual patients were included. Results Amniotic fluid embolism was the most frequently reported indication for ECMO use. The mean duration of ECMO support was 4.2 days. Twelve patients required mechanical ventilation for a mean of 15.3 days. Maternal survival was high, with only one reported death. Ten patients experienced uneventful recoveries. Among the survivors, four reported neurological sequelae, such as weakness and neurocognitive dysfunction. Conclusion Our results suggest that extracorporeal membrane oxygenation use in the obstetric population for hemodynamic collapse during or immediately following Caesarean section is associated with good maternal survival to discharge. Despite the severity of presentation, maternal survival to hospital discharge was favorable. Further prospective studies are needed to better define patient selection, timing, and long-term outcomes in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.009 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".