Maternal out-of-hospital cardiac arrest: A retrospective observational study

Maurin, Olga; Lemoine, Sabine; Jost, Daniel; Lanoë, Vincent; Renard, Aurélien; Travers, Stéphane; Lapostolle, Frédéric; Tourtier, Jean Pierre

doi:10.1016/j.resuscitation.2018.11.001

Cited by 22 publications

(21 citation statements)

References 18 publications

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“…Since the 2015 CoSTR, 1 , 7 7 new small observational studies were identified, 5 of which focused on association of timing of delivery with outcome of cardiac arrest and other factors associated with maternal and fetal mortality. 138 , 139 , 140 , 141 , 142 Due to the very small size of most studies, an updated SysRev was not suggested. The 2015 treatment recommendation remains unchanged.…”

Section: Cardiac Arrest In Special Circumstancesmentioning

confidence: 99%

Adult Advanced Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations

et al. 2020

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This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations for advanced life support includes updates on multiple advanced life support topics addressed with 3 different types of reviews. Topics were prioritized on the basis of both recent interest within the resuscitation community and the amount of new evidence available since any previous review. Systematic reviews addressed higher-priority topics, and included double-sequential defibrillation, intravenous versus intraosseous route for drug administration during cardiac arrest, point-of-care echocardiography for intra-arrest prognostication, cardiac arrest caused by pulmonary embolism, postresuscitation oxygenation and ventilation, prophylactic antibiotics after resuscitation, postresuscitation seizure prophylaxis and treatment, and neuroprognostication. New or updated treatment recommendations on these topics are presented. Scoping reviews were conducted for anticipatory charging and monitoring of physiological parameters during cardiopulmonary resuscitation. Topics for which systematic reviews and new Consensuses on Science With Treatment Recommendations were completed since 2015 are also summarized here. All remaining topics reviewed were addressed with evidence updates to identify any new evidence and to help determine which topics should be the highest priority for systematic reviews in the next 1 to 2 years.

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Section: Cardiac Arrest In Special Circumstancesmentioning

confidence: 99%

Adult Advanced Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations

et al. 2020

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“…No studies had previously been performed in the out-of-hospital setting, as our study was. Two recent studies conducted in France and Canada measured the incidence, results and follow-up of the guidelines in the care of MCA at the out-of-hospital level [1,5]. In Canada, six cases of MCA were recorded, of which only one mother and two newborns survived to hospital discharge, although three mothers did present ROSC (two of them before arriving at the hospital); maternal survival at hospital discharge was 16.6%, lower than the 59% recorded in cases of in-hospital MCA.…”

Section: Discussionmentioning

confidence: 99%

“…In all cases, the recording of the quality of the compressions was good, and the route was channelled at the supradiaphragmatic level, but in no case was the uterus manually moved to the left during the transfer, and only in one case was the patient lateralized (measure not currently recommended if sufficient resources are available because the quality of compressions decreases) [1]. In France, 16 cases of CA in pregnant women were recorded, of which 10 occurred over 20 gestational weeks; only two women survived to hospital discharge (none were pregnant for more than 20 weeks), no team lateralized the uterus, [5] and the average transfer time to the hospital was 94 minutes. The lack of uterine lateralization may be due to lack of knowledge, the fact that they did not know the patient was over 20 gestational weeks or that the manoeuvre was not recorded.…”

Section: Discussionmentioning

confidence: 99%

“…Fortunately, the probability that a pregnant patient suffers from CA is very small, since pregnant women are usually young and healthy (incidence of in-hospital Maternal Cardiac Arrest (MCA) varies from 1:20,000-1:12,000 pregnancies); [1,2] at the out-of-hospital level in Canada, the incidence is 1.71:100,000 pregnancies) [1]. However, MCA and maternal mortality are frequently underestimated and underreported in 22-67% of cases, [3,4] particularly at the out-of-hospital level if there are no witnesses to indicate that the woman is pregnant [5].…”

Section: Introductionmentioning

confidence: 99%

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2018

RMGO

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Objective: To analyse the level of knowledge of out-of-hospital emergency care personnel on the management of Cardiac Arrest (CA) in pregnant women, to determine whether there are deficiencies in training and to assess the creation of a course on cardiopulmonary resuscitation in pregnant women for non-obstetric personnel. Materials and methods: We analysed the results of five questions addressing the management of CA in pregnant women from a questionnaire conducted prior to the Out-of-Hospital Obstetric Emergencies course to determine the level of knowledge of doctors and nurses regarding out-of-hospital emergencies in the management of CA in pregnant women. Results: After analysing four questions related to the management of CA in pregnant women, the mean proportion of correct answers was 54.48%; only 21.79% of participants answered all questions correctly, and 14.4% did not answer any questions correctly. Regarding professionals' perceptions about their abilities to perform CPR in a pregnant woman, 67.12% of students did not think they were sufficiently trained to perform resuscitation in a pregnant woman, and 79.3% did not know how to perform a perimortem caesarean section. Conclusion: There are deficiencies in the knowledge about the management of resuscitation in a pregnant woman; moreover, outof-hospital emergency care personnel perceived a lack of training on this subject. Therefore, an Advanced Cardiac Life Support in Pregnancy course must be created for staff who do not work in a delivery room, since these training needs are not covered in Advanced Cardiac Life Support in Adults courses.

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“…Furthermore, data in the literature suggested that SCD may occur as a consequence of a trigger factor in the context of electrical or structural heart disorder (genetic or acquired), which acts as a predisposing condition. Known exogenous triggers resulting in the fatal event of SCD may be fever, alcohol intake, electrolyte disorders, hypertensive crisis, infection, cytotoxic drugs, and pregnancy [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Moreover, regular physical activity is an important exogenous factor affecting the risk of SCD in predisposed subjects.…”

Section: Introductionmentioning

confidence: 99%

The Hidden Fragility in the Heart of the Athletes: A Review of Genetic Biomarkers

Barretta

Mirra

Monda

et al. 2020

IJMS

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Sudden cardiac death (SCD) is a devastating event which can also affect people in apparent good health, such as young athletes. It is known that intense and continuous exercise along with a genetic background that predisposes a person to the risk of fatal arrhythmias is a trigger for SCD. Therefore, knowledge of the athlete’s genetic conditions underlying the onset of SCD must be extended, in order to develop new effective prevention and/or therapeutic strategies. Arrhythmic features occur across a broad spectrum of cardiac diseases, sometimes presenting with overlapping phenotypes. The genetic basis of arrhythmogenic disorders has been greatly highlighted in the last 30 years, and has shown marked heterogeneity. The advent of next-generation sequencing has constantly updated our understanding of the genetic basis of arrhythmogenic diseases and is laying the foundation for precision medicine. With the exception of a few clinical cases involving a single athlete showing a highly suspected phenotype for the presence of a heart disease, there are few studies to date that analysed the applicability of genetic testing on cohorts of athletes. This evidence shows that genetic testing can contribute to the diagnosis of up to 13% of athletes; however, the presence of clinical markers is essential. This review aims to provide a reference collection on current knowledge of the genetic basis of sudden cardiac death in athletes and to review updated evidence on the effectiveness of genetic testing in early identification of athletes at risk for SCD.

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Maternal out-of-hospital cardiac arrest: A retrospective observational study

Cited by 22 publications

References 18 publications

Adult Advanced Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations

Adult Advanced Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations

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The Hidden Fragility in the Heart of the Athletes: A Review of Genetic Biomarkers

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