Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training?

Dijkman, A.; Huisman, Cynthia; Smit, Marrit; Schutte, Joke M.; Zwart, Joost J.; Roosmalen, J.J. van; Oepkes, Dick

doi:10.1111/j.1471-0528.2009.02461.x

Cited by 183 publications

(95 citation statements)

References 14 publications

(19 reference statements)

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“…28 Survival of the mother has been reported up to 15 minutes after the onset of maternal cardiac arrest. 21,[29][30][31] Neonatal survival has been documented with PMCD performed up to 30 minutes after the onset of maternal cardiac arrest.…”

Section: Emergency Cesarean Delivery In Cardiac Arrestmentioning

confidence: 99%

“…[21][22][23][24][25] In the latter half of pregnancy, PMCD may be considered part of maternal resuscitation, regardless of fetal viability. 26 In a case series, 12 of 20 women for whom maternal outcome was recorded who underwent PMCD during resuscitation had return of spontaneous circulation (ROSC) immediately after delivery, A systematic review of the literature evaluated all case reports of cardiac arrest in pregnancy, but the wide range of case heterogeneity and reporting bias does not allow for any conclusions regarding the timing of PMCD.…”

Section: Emergency Cesarean Delivery In Cardiac Arrestmentioning

confidence: 99%

See 1 more Smart Citation

Part 10: Special Circumstances of Resuscitation

Lavonas¹,

Drennan²,

Gabrielli³

et al. 2015

Circulation

239

123

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Section: Emergency Cesarean Delivery In Cardiac Arrestmentioning

confidence: 99%

Section: Emergency Cesarean Delivery In Cardiac Arrestmentioning

confidence: 99%

Part 10: Special Circumstances of Resuscitation

Lavonas¹,

Drennan²,

Gabrielli³

et al. 2015

Circulation

239

123

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“…For the critical outcomes of survival with favorable neurologic/functional outcome at discharge, 30 days, 60 days, 180 days, and/or 1 year, and survival only at discharge, 30 days, 60 days, 180 days, and/or 1 year, and the important outcomes of ROSC, we found 3 observational studies of 154 subjects collectively [150][151][152] that provided very-low-quality evidence (downgraded for very serious risk of bias and imprecision, and serious inconsistency) comparing cardiac arrest resuscitation with or without perimortem cesarean delivery. The procedures to ascertain cases and controls in these studies were significantly different so that the pooled comparison of any of the assigned outcomes is considered inappropriate.…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 4: Advanced Life Support

Nolan¹,

Hazinski²,

Aickin³

et al. 2015

Circulation

554

125

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Questions to be addressed (using the PICO [population, intervention, comparator, outcome] format) 3 were prioritized by ALS Task Force members (by voting). Prioritization criteria included awareness of significant new data and new controversies or questions about practice. Questions about topics no longer relevant to contemporary practice or where little new research has occurred were given lower priority. The ALS Task Force prioritized 42 PICO questions for review. With the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk of bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 for studies of diagnostic accuracy, 5 and GRADE for observational studies that inform both therapy and prognosis questions. 6 GRADE evidence profile tables 7 were then created to facilitate an evaluation of the evidence in support of each of the critical and important outcomes. The quality of the evidence (or confidence in the estimate of the effect) was categorized as high, moderate, low, or very low, 8 based on the study methodologies and the 5 core GRADE domains of risk of bias, inconsistency, indirectness, imprecision, and other considerations (including publication bias). 9 These evidence profile tables were then used to create a written summary of evidence for each outcome (the consensus on science statements). Whenever possible, consensus-based treatment recommendations were then created. These recommendations (designated as strong or weak) were accompanied by an overall assessment of the evidence and a statement from the task force about the values, preferences, and task force insights that underlie the recommendations. Further details of the methodology that underpinned the evidence evaluation process are found in "Part 2: Evidence Evaluation and Management of Conflicts of Interest."The task force preselected and ranked outcome measures that were used as consistently as possible for all PICO questions. Longer-term, patient-centered outcomes were considered more important than process variables and shorter-term outcomes. For most questions, we used the following hierarchy starting with the most important: long-term survival with neurologically favorable survival, long-term survival, short-term survival, and process variable. In general, longterm was defined as from hospital discharge to 180 days or longer, and short-term was defined as shorter than to hospital discharge. For certain questions (eg, related to defibrillation or confirmation of tracheal tube position), process variables such as termination of fibrillation and correct tube placement were important. A few questions (eg, organ donation) required unique outcomes....

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“…The cesarean delivery early in resuscitation may be lifesaving for the mother because it alleviates aortocaval compression. 187 …”

Section: Clinical Statements and Guidelinesmentioning

confidence: 99%

“…187 If resuscitation is ongoing for 4 minutes and the uterus is sufficiently large to cause aortocaval compression, a cesarean section should be performed. The cesarean delivery early in resuscitation may be lifesaving for the mother because it alleviates aortocaval compression.…”

Section: Clinical Statements and Guidelinesmentioning

confidence: 99%

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

Canobbio¹,

Warnes²,

Aboulhosn³

et al. 2017

Circulation

335

303

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Today, most female children born with congenital heart disease will reach childbearing age. For many women with complex congenital heart disease, carrying a pregnancy carries a moderate to high risk for both the mother and her fetus. Many such women, however, do not have access to adult congenital heart disease tertiary centers with experienced reproductive programs. Therefore, it is important that all practitioners who will be managing these women have current information not only on preconception counseling and diagnostic evaluation to determine maternal and fetal risk but also on how to manage them once they are pregnant and when to refer them to a regional center with expertise in pregnancy management.

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Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training?

Cited by 183 publications

References 14 publications

Part 10: Special Circumstances of Resuscitation

Part 10: Special Circumstances of Resuscitation

Part 4: Advanced Life Support

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

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