Maternal cardiac arrest: a retrospective analysis

Abstract

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.

Maternal cardiac arrest secondary to choriosepsis after preterm premature rupture of membranes

“…One study showed that chorioamnionitis was found in 4.9% of maternal cardiac arrests, and sepsis from any source was present in 8.8% of maternal cardiac arrests. 8 Unfortunately, 40% of cardiac arrests related to sepsis result in death. 9 Ampicillin and gentamicin are standard therapies for chorioamnionitis.…”

Arrêt cardiaque maternel secondaire à une chorioamnionite compliquée d’une septicémie après rupture prématurée des membranes

“…L'arrêt cardiaque chez la mère est une complication rare de la grossesse et du postpartum. Une étude a montré que la chorio amnionite était présente dans 4,9 % et la septicémie, quelle qu'en soit la source, dans 8,8 % des arrêts cardiaques maternels 8 . Malheureusement, 40 % des arrêts cardiaques liés à la septicé mie sont fatals 9 .…”

Miles to go…

“…In their data, Liu et al have reported very high survival (77.8%) among those who underwent PMCS, in contrast to most of the available literature. 1,2 We congratulate the authors on this. However, we feel that discussing more details -in particular the time-frame between cardiac arrest and delivery -would help those with less expertise, should such an unfortunate event ever occur in their practice.…”

“…Dear Dr Papageorghiou, We read the retrospective data on maternal cardiac arrest by Liu et al 1 with a lot of interest. This was especially intriguing to us, as maternal cardiac arrest is not well-reported from resource-limited countries like India.…”

“…To our surprise, survival of patients with a diagnosis of amniotic fluid embolism was higher (63.6%) than that for women with postpartum haemorrhage (52.6%). 1 It would have given us more insight if the authors had expanded on this entity, which is usually a diagnosis of exclusion. It raises another important query in our mind: could delays in transport in women with postpartum haemorrhage who are referred from other centres for better care, be a big culprit for poorer outcome?…”