A 26-year-old pregnant woman, with multiple metastatic Ewing sarcoma, presented with a sternal mass that began enlarging during pregnancy. Due to high-risk pregnancy, the patient was discussed in a multidisciplinary meeting and intubation was considered too risky without cardiopulmonary support. Computed tomography showed extrinsic tumor compression of the right ventricle outflow tract. Veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) was initiated before general anesthesia, followed by Cesarean section (C-section). VA ECMO was initiated with the patient in the awake position, ECMO support was discontinued when the patient had stable ventilation and hemodynamics. This case represents a unique indication of VA ECMO, during C-section, with maternal and fetal survival.

中文翻译：

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需要 VA-ECMO 支持的转移性尤文肉瘤患者的剖宫产术

一名 26 岁孕妇，患有多发性转移性尤文肉瘤，出现胸骨肿块，在怀孕期间开始增大。由于高危妊娠，在多学科会议上讨论了该患者，认为在没有心肺支持的情况下插管风险太大。计算机断层扫描显示右心室流出道外源性肿瘤压迫。静脉-动脉（VA）体外膜肺氧合（ECMO）在全身麻醉前开始，然后是剖腹产（剖腹产）。VA ECMO 开始时患者处于清醒位置，当患者通气和血流动力学稳定时停止 ECMO 支持。该病例代表了剖腹产期间 VA ECMO 的独特指示，具有母婴存活。