Outcomes of Extracorporeal Membrane Oxygenation in Pregnant vs. Non-Pregnant Women with Cardiogenic Shock: A Nationwide Analysis

Manoj Ghimire; Sajana Poudel; Kalpana Ghimire; Karun Shrestha; Prakriti Subedi; Salomon Chamey; Suleman Celaj; Dinesh Kadariya; Paolo Colombo; Sanjay Chaudhary

doi:10.71295/JHDT.2025.020101

Authors

Manoj Ghimire MD, Internal Medicine Resident, St Barnabas Hospital, Bronx, New York, USA.
Sajana Poudel MD, Internal Medicine Resident, Cook County Health, Chicago, IL, USA.
Kalpana Ghimire MD, Internal Medicine Resident, St Barnabas Hospital, Bronx, New York, USA.
Karun Shrestha MD, Internal Medicine Resident, St Barnabas Hospital, Bronx, New York, USA.
Prakriti Subedi Internal Medicine Resident, St Barnabas Hospital, Bronx, New York, USA.
Salomon Chamey MD, Internal Medicine Resident, St Barnabas Hospital, Bronx, New York, USA.
Suleman Celaj MD, Department of Cardiology, St Barnabas Hospital, Bronx, New York, USA.
Dinesh Kadariya MD, Assistant Professor Department of Cardiology, University of Florida, Jacksonville, Florida, USA.
Paolo Colombo MD, Professor, Department of Cardiology, Columbia University of New York, New York USA.
Sanjay Chaudhary Assistant Professor, MD, Department of Critical Care, Mayo Clinic Florida, Jacksonville, Florida, USA.

DOI:

https://doi.org/10.71295/JHDT.2025.020101

Keywords:

ECMO, Pregnancy, Cardiogenic shock

Abstract

Introduction: Cardiovascular disease is the leading cause of pregnancy-related mortality in the U.S., with rise in heart failure and cardiogenic shock. The use of Extracorporeal Membrane Oxygenation (ECMO) in cardiogenic shock is increasing, however, data on its use in pregnancy remain limited. This study aimed to assess the utilization and outcomes of ECMO in pregnant and postpartum women admitted to the hospital with cardiogenic shock.
Methods: We conducted a nationwide retrospective study using the National Inpatient Sample (2016–2021) to evaluate ECMO utilization and outcomes in pregnant and postpartum women with cardiogenic shock. Demographic characteristics, hospital charges, complications, and clinical outcomes were compared in two groups of study population.
Results: Among 44,940 women of reproductive age with cardiogenic shock, 3,640 (8.1%) received ECMO, including 145 pregnant/postpartum women. Pregnant/postpartum women were younger (31.2 vs. 36.3 years, p<0.001), had fewer cardiovascular comorbidities, and had lower mortality rates (17.2% vs. 37.05%, p=0.03). Hospital charges were lower ($661,143 vs. $955,654, p<0.001). Complication rates, including venous thromboembolism, pulmonary embolism, major bleeding, stroke, need for mechanical ventilation, and renal replacement therapy, were similar between groups.
Conclusion: ECMO remains a life-saving intervention for pregnant women with cardiogenic shock, demonstrating comparable outcomes to non-pregnant women.