The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Management of Cardiac Arrest in Pregnancy

Abstract

This consensus statement was commissioned in 2012 by the Board of Directors of the Society for Obstetric Anesthesia and Perinatology to improve maternal resuscitation by providing health care providers critical information (including point-of-care checklists) and operational strategies relevant to maternal cardiac arrest. The recommendations in this statement were designed to address the challenges of an actual event by emphasizing health care provider education, behavioral/communication strategies, latent systems errors, and periodic testing of performance. This statement also expands on, interprets, and discusses controversial aspects of material covered in the American Heart Association 2010 guidelines.

The CAPS Study: incidence, management and outcomes of cardiac arrest in pregnancy in the UK: a prospective, descriptive study

“…These data clearly showed that maternal survival is related to the place of collapse. Current teaching suggests that PMCS should be performed within 5 minutes of maternal cardiac arrest, where cardiac output is not restored, to improve maternal outcome, with potential additional benefit to fetal outcome. Our data support this; however, we must accept that in many women, the delay in PMCS was because they collapsed at home and not due to a delay within a hospital setting.…”

“…Dutch data suggest a reduction in the reluctance to perform PMCS as a result of maternity‐specific training; however, few were carried out within the prescribed 5 minutes and overall maternal survival was poor . American data show that up to one‐third of women who arrest die with their baby still in utero . We have shown a very different approach in the UK; 49 of the 66 women had a PMCS.…”

“…Of the 17 remaining women, only two (7% of non‐surviving women) failed to be delivered by PMCS when they could have been, one because of lack of equipment and one who died at home. This is approaching a fivefold improvement when compared with the American data . Consultants were involved in the majority of decisions to perform PMCS and conducted most of them, in keeping with the move to involve senior clinicians.…”

Estudio de mortalidad materna por sepsis en Antioquia, Colombia, entre los años 2004-2014: una mirada al desafío de la identificación y el tratamiento oportunos

“…ej., PEEP > 10 mm/Hg, FiO2: 100 %). Esta variable se construyó por consenso, con base en la experiencia del grupo investigador, y por aplicación de evidencia indirecta (manejo del paro cardiorrespiratorio y del síndrome de dificultad respiratorio agudo en el embarazo) (22,23).…”

Managing cardiac emergencies in pregnancy

“…Several guidelines provide practical advices concerning the treatment of maternal cardiac arrest, which are summarised in table 1 67 68. Immediate basic life support and, when available, advanced life support should be initiated as outside pregnancy.…”