Cardiac Arrest in Pregnancy

Abstract

Abstract-This is the first scientific statement from the American Heart Association on maternal resuscitation. This document will provide readers with up-to-date and comprehensive information, guidelines, and recommendations for all aspects of maternal resuscitation. Maternal resuscitation is an acute event that involves many subspecialties and allied health providers; this document will be relevant to all healthcare providers who are involved in resuscitation and specifically maternal resuscitation. Key Words: AHA Scientific Statements ■ cardiopulmonary resuscitation ■ heart arrest ■ pregnancy © 2015 American Heart Association, Inc.Circulation is available at http://circ.ahajournals.org DOI: 10.1161/CIR.0000000000000300The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on July 6, 2015, and the American Heart Association Executive Committee on August 24, 2015. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl/doi:10.1161/CIR.0000000000000300/-/DC1. The American Heart Association requests that this document be cited as follows: Jeejeebhoy FM, Zelop CM, Lipman S, Carvalho B, Joglar J, Mhyre JM, Katz VL, Lapinsky SE, Einav S, Warnes CA, Page RL, Griffin RE, Jain A, Dainty KN, Arafeh J, Windrim R, Koren G, Callaway CW; on behalf of the American Heart Association Emergency Cardiovascular Care Committee, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Cardiovascular Diseases in the Young, and Council on Clinical Cardiology. Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation. 2015;132:1747-1773 Expert peer review of AHA Scientific Statements is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit http://my.americanheart.org/statements and select the "Policies and Development" link.Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.heart.org/HEARTORG/General/CopyrightPermission-Guidelines_UCM_300404_Article.jsp. A link to the "Copyright Permissions Request Form" appears on the right ...

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

“…Cardiac arrest occurs in 1 in 30 000 pregnancies, 185 with CHD being the third most common cause of arrest in cardiac patients. Management is in accord with current resuscitation guidelines with the same protocols as for nonpregnant patients 185,186 with modifications that account for the impact of the gravid uterus on maternal cardiopulmonary function.…”

“…Management is in accord with current resuscitation guidelines with the same protocols as for nonpregnant patients 185,186 with modifications that account for the impact of the gravid uterus on maternal cardiopulmonary function. At a gestation age of 20 weeks and beyond, the pregnant uterus can press against the inferior vena cava and the aorta, impeding venous return and cardiac output.…”

“…186 In accordance with the 2015 guidelines, a "bundled emergency code call" (eg, maternal code blue) to all necessary responders may save time and avoid confusion. 185 This team should include obstetrics, obstetrical anesthesiology, cardiology, and neonatology.…”

“…Although there is a small risk of fetal arrhythmias, defibrillation is considered safe at all stages of pregnancy. 185 Additionally, if fetal monitoring is being used, it should be removed during defibrillation. Intravenous access should be above the umbilicus (diaphragm) because medications and volume given via femoral access may be limited by aortocaval compression by the uterus.…”

High Energy Trauma and Pregnancy

“…2015 yılında Amerikan Kalp Vakfı (AHA), gebe olan bir hasta ile olmayan hasta arasında göğüs kompresyonu uygulama şekli arasında farklılık olmadığını belirtmiştir (19) .…”