Cardiac arrest in pregnancy

Kikuchi, Jacqueline Y.; Deering, Shad

doi:10.1053/j.semperi.2017.11.007

Cited by 38 publications

(22 citation statements)

References 26 publications

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“…Maternal cardiac arrest (MCA) is a rare but serious clinical event that poses a significant threat to both maternal and fetal health despite its low mortality. Sufficient preparation for such an emergency is of paramount importance for every obstetrician 1 . Although recent reports have shown a rising incidence of MCA in the Netherlands and other countries, 2,3 detailed studies of MCA in China remain limited.…”

Section: Introductionmentioning

confidence: 99%

“…Early identification and effective management of MCA can improve maternal and fetal prognosis. 1 Maternal survival is related to the location of the MCA event, the interval between MCA collapse and emergency procedures, the patient's body mass index (BMI) and other factors. 6 The specific location at which an MCA event occurs is a crucial prognostic factor.…”

Section: Introductionmentioning

confidence: 99%

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Maternal cardiac arrest: a retrospective analysis

Liu

et al. 2021

BJOG

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Objectives To describe the characteristics and factors which may influence the maternal outcomes of maternal cardiac arrest (MCA). Design Retrospective analysis of cases. Setting China. Population or sample A total of 61 MCA patients admitted or transferred to The Third Affiliated Hospital of Guangzhou Medical University from January 2000 to December 2019. Methods Clinical data for MCA were analysed retrospectively. The indicators included maternal age; BMI; gestational age; antenatal examination; income; MCA cause and place; cardiopulmonary resuscitation (CPR); mode of delivery; maternal prognosis; and neonatal outcome. Main outcome measures The impact of case characteristics on maternal prognosis of MCA. Results The hospital received 61 patients with MCA, 36 of whom died (mortality 59.0%, 95% CI 46.3–71.7%). MCA was predominantly caused by treatable complications. Those who died were more likely to have collapsed in the ICU. Conclusions Regular antenatal examination and early intervention can reduce the incidence of adverse pregnancy outcomes. The location of MCA occurred may be related to maternal prognosis. The leading causes of MCA were postpartum haemorrhage and amniotic fluid embolism. Tweetable abstract A retrospective analysis describes the correlation between case characteristics of MCA and maternal outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Maternal cardiac arrest: a retrospective analysis

Liu

et al. 2021

BJOG

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“…In standard CPR, resuscitation teams often deviate from algorithms of CPR, and evidence suggests that in addition to technical skills of individual rescuers, human factors such as teamwork affect the quality of CPR [15]. Correct and timely interventions has been shown to affect outcomes after cardiac arrest in pregnancy [16]. This requires highly skilled and competent rescuers.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a questionnaire to assess healthcare personnel competence in cardiac arrest and resuscitation in pregnancy

et al. 2020

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Background Cardiac arrest is rare in pregnancy, and up-to date competence can be difficult to assess and maintain. The objective of this study was to develop and validate a questionnaire to assess healthcare personnel experiences, self-assessed competence and perception of role and resposibility related to cardiac arrest and cardio-pulmonary resuscitation (CPR) in pregnancy Methods The study had a cross-sectional design, developing and validating a questionnaire: the Competence in cardiac arrest and CPR in pregnancy (ComCA-P). Development and validation of the ComCA-P was conducted in three stages: 1) Literature review and expert group panel inputs, 2) a pilot study and 3) a cross-sectional questionnaire study. In stage one, the ComCA-P was developed over several iterations between the researchers, including inputs from an expert group panel consisting of highly competent professionals (n = 11). In stage two, the questionnaire was piloted in a group of healthcare personnel with relevant competence (n = 16). The ComCA-P was then used in a baseline study including healthcare personnel potentially involved in CPR in pregnancy (n = 527) in six hospital wards. Based on these data, internal consistency, intra-class correlations, and confirmatory factor analysis were utilized to validate the questionnaire. Results The expert group and pilot study participants evaluated the appropriateness, relevance and accuracy to be high. Formulation of the items was considered appropriate, with no

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“…The increased likelihood of cardiac arrest (in the unadjusted model) among Hispanic pregnant women being treated for acute appendicitis, compared to Hispanics without acute appendicitis, was another notable finding. Cardiac arrest in those with acute appendicitis could stem from several complications including negative appendectomy, complications caused by anesthesia, or surgical accidents that result in bleeding [ 10 , 22 ]. Although it is unclear what may contribute toward the increased likelihood of cardiac arrest among Hispanics with versus those without appendicitis, some of the likely reasons could be restricted access to health care, delayed prenatal care, late presentation, limited accessibility to facilities which are equipped with expertise and infrastructure to attend to these emergencies etc.…”

Section: Resultsmentioning

confidence: 99%

“…Although it is unclear what may contribute toward the increased likelihood of cardiac arrest among Hispanics with versus those without appendicitis, some of the likely reasons could be restricted access to health care, delayed prenatal care, late presentation, limited accessibility to facilities which are equipped with expertise and infrastructure to attend to these emergencies etc. [ 22 , 23 ]. The paucity of numbers of cardiac arrest in NH-White and NH-Black women with appendicitis hampered evaluation of racial/ethnic disparities across these groups.…”

Section: Resultsmentioning

confidence: 99%

Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal–Fetal Mortality

et al. 2020

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Background Appendicitis is the most common extra-uterine surgical emergency requiring immediate intervention during pregnancy. However, risks for mortality and morbidity among pregnant women with appendicitis remain poorly understood. This study was conducted to determine the temporal trends of appendicitis in pregnant women, and to calculate the risk of maternal–fetal mortality and near-miss marker (i.e., cardiac arrest) among pregnant women in general, and by race/ethnicity. Methods We conducted this retrospective study using data from the Nationwide Inpatient Sample (NIS) from January 1, 2002, through December 31, 2015. Joinpoint regression was used to estimate and describe temporal changes in the rates of all and acute appendicitis during the 14-year study period. We also estimated the risk of cardiac arrest, maternal, and fetal mortality among mothers of various racial/ethnic groups with a diagnosis of acute appendicitis. Within each group, patients without acute appendicitis were the referent category. Results and conclusions Out of the 58 million pregnancy hospitalizations during the study period, 63,145 cases (10.74 per 10,000 hospitalizations) were for acute appendicitis. There was a 5% decline (95% CI: − 5.1, − 5.0) in the rate of appendicitis hospitalizations over the period of the study. After adjusting for covariates, pregnant mothers with acute appendicitis had increased likelihood when compared to those without acute appendicitis to suffer fetal loss (OR: 2.05, 95% CI: 1.85–2.28) and nearly fivefold increase for inpatient maternal death. In conclusion, appendicitis during pregnancy remains an important cause of in-hospital maternal–fetal mortality overall and regardless of race/ethnicity.

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Cardiac arrest in pregnancy

Cited by 38 publications

References 26 publications

Maternal cardiac arrest: a retrospective analysis

Maternal cardiac arrest: a retrospective analysis

Development and validation of a questionnaire to assess healthcare personnel competence in cardiac arrest and resuscitation in pregnancy

Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal–Fetal Mortality

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