The use of extracorporeal membrane oxygenation in obstetrics in the Russia according to ELSO, «ROSECMO» and Obstetric «Near-miss» Register

Introduction. Extracorporeal membrane oxygenation is demanding extensive resources intensive care method and is used as a temporary measure to compensate for respiratory and/or heart failure in potentially reversible diseases and conditions, or as a “bridge” to transplantation of the affected organ (heart, lungs) or the use of long-term support (artificial ventricle or ventricles of the heart) for its function. Significant events that influenced the introduction of the technique into broad clinical practice were outbreaks of infectious diseases characterized by lung damage with the development of severe respiratory failure, including the 2009–2011 H1N1 influenza pandemic, the 2012 MERS-Cov coronavirus epidemic and the 2019–2022 SARSCov-19 new coronavirus pandemic. The purpose of the study: to analyze the use of ECMO in obstetric “near-miss” cases. Materials and methods. The data of the international registry Extracorporeal Life Support Organization (1997–2023), the Russian Society of ECMO Specialists “ROSECMO” (2011–2023) and the Russian Obstetric “Near-Miss” Registry (2021–2023) are analyzed. Results. The ELSO registry has registered 263 cases of ECMO in obstetrics, with a survival rate 70%. There are only 502 cases of ECMO in the “ROSECMO” Registry (there is no division into obstetric and general patients) with a survival rate of 85%. Cases are entered into the “ROSECMO” Registry on the initiative of the physician, on a voluntary basis. The true rate of survival and discharge of patients using the ECMO method from the hospital in Russia is unknown, judging by individual sources it is 10–13%. Russian Obstetric “Near-Miss” Registry –  103 obstetric patients with a survival rate of 32%. Conclusion. Compared with the “ROSECMO” and “ELSO” registers, the Russian Obstetric “Near-Miss” Registry contains the most complete and reliable data on the use of ECMO among obstetric patients. Unlike voluntary, and therefore subjective (mostly cases with a favorable outcome are entered) data entry into the ROSECMO and ELSO registers, data on all cases of ECMO use in obstetric practice in Russia are transferred to the Obstetric “Near-Miss” Registry. The survival rate of obstetric patients when transferred to ECMO is higher than the survival rate in the general population in the Russian Federation. There are reserves for the prevention of maternal deaths with timely and proper use of the ECMO method.

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