Update: Focus in-hospital maternal cardiac arrest

C Fischer; M P Bonnet; A Girault; C Le Ray

doi:10.1016/j.jogoh.2019.02.007

Update: Focus in-hospital maternal cardiac arrest

J Gynecol Obstet Hum Reprod. 2019 May;48(5):309-314. doi: 10.1016/j.jogoh.2019.02.007. Epub 2019 Feb 20.

Authors

C Fischer¹, M P Bonnet², A Girault³, C Le Ray³

Affiliations

¹ Department of Anesthesiology and Critical Care, Hôpital Cochin, Hôpitaux Universitaire Paris Centre, Assistance Publique- Hôpitaux de Paris, France. Electronic address: catherine.fischer2@aphp.fr.
² Department of Anesthesiology and Critical Care, Hôpital Cochin, Hôpitaux Universitaire Paris Centre, Assistance Publique- Hôpitaux de Paris, France; INSERM U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
³ INSERM U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France; Port-Royal Maternity Unit, Cochin Hospital, Hôpitaux Universitaires Paris Centre, Assistance Publique-Hôpitaux de Paris, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.

PMID: 30796984
DOI: 10.1016/j.jogoh.2019.02.007

Abstract

The incidence of maternal cardiac arrest ranges from 1/55,000 to 1/12,000 births. It is due most frequently to cardiovascular, hemorrhagic, and anesthesia-related causes, as well as to amniotic fluid embolism. The basic principles of resuscitation remain applicable in this situation, but the physiological modifications of pregnancy must be taken into account, in particular, the aortocaval compression syndrome. After 24 weeks of gestation, a salvage cesarean delivery must be performed immediately, without transfer to the operating room, if resuscitation maneuvers have failed 4 min after arrest, because this interval conditions the mother's neurological prognosis and improves neonatal survival.

Publication types

Review

MeSH terms

Advanced Cardiac Life Support
Cardiopulmonary Resuscitation
Cesarean Section
Embolism, Amniotic Fluid
Extracorporeal Membrane Oxygenation
Female
Heart Arrest / etiology
Heart Arrest / therapy*
Hospitalization*
Humans
Incidence
Parturition
Pregnancy
Pregnancy Complications, Cardiovascular / therapy*
Prognosis
Risk Factors