- •Peripartum use of mechanical circulatory support increased from 2002 – 2014.
- •Overall mortality for pregnant women receiving mechanical support has not decreased.
- •The most common type of mechanical support used was an intra-aortic balloon pump.
- •Probability of death increased when mechanical support was used on or after day 6.
Objectives
To systematically explore the relationship among the use of mechanical circulatory support (MCS), the timing of placement, and outcomes in pregnancy.
Setting
United States hospitals.
Participants
A weighted sample of women who received MCS during the antepartum, delivery, or postpartum period between 2002 and 2014.
Interventions
MCS
Measurements and Main Results
There were 1,386 women who received MCS during their admission. These women were older and had more comorbidities than women without MCS. The mean time from admission to device placement was 5.4 days for all women, and MCS use was highest in urban teaching hospitals. Overall, peripartum use of MCS has increased since 2002, but mortality did not change during the same period. After adjusting for potential confounders, the odds ratio for mortality when MCS was placed within 6 days of admission was 0.48 (95% confidence interval 0.23-0.98) with the adjusted probability of death rising from 18.6% to 32.5% when the device was placed on or after day 6.
Conclusions
Similar to trends in the general population, use of MCS has increased in the peripartum period. Women receiving MCS were generally older and had more comorbidities than those not receiving MCS. Increased time to device placement may worsen mortality. Further research will help identify appropriate candidates and factors that improve survival.