Management of cardiac arrest in pregnancy: A systematic review

Jeejeebhoy, Farida M.; Zelop, Carolyn M.; Windrim, Rory; Carvalho, Jose C. A.; Dorian, Paul; Morrison, Laurie J.

doi:10.1016/j.resuscitation.2011.01.028

Cited by 84 publications

(53 citation statements)

References 31 publications

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“…20 For example, a review of cases in The Netherlands between 1993 and 2008 17 showed that of eight in-hospital arrests no PMCDs were performed in less than IQR = interquartile range, PMCD = perimortem Cesarean delivery *Wilcoxon rank sum test for differences in time to PMCD over baseline between groups: Z = 0.00, P = 1.00…”

Section: Discussionmentioning

confidence: 99%

Management of simulated maternal cardiac arrest by residents: didactic teaching versus electronic learning

Hards

Davies

Salman

et al. 2012

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 99%

Management of simulated maternal cardiac arrest by residents: didactic teaching versus electronic learning

Hards

Davies

Salman

et al. 2012

Can J Anesth/J Can Anesth

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“…6 More importantly, evacuation of the gravid uterus makes successful maternal resuscitation much more likely regardless of gestational age. 2,7 In a resuscitation scenario during which the application of good-quality chest compressions produces no palpable maternal pulse, uterine evacuation should be expedited. The release of aortocaval compression and autotransfusion effects may potentially facilitate attempts at maternal resuscitation.…”

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confidence: 99%

“…These observations are consistent with other case reports. 7,10 The authors not only identified poor documentation for each of the five cases, but they also reported the difficulty in organizing and mobilizing the team to initiate the emergent Cesarean delivery within four minutes post-arrest. Rather than conclude that perhaps it is acceptable to delay the decision and start of surgery, there are other lessons to be learned; for example, all practitioners practicing in a hospital providing obstetrical services need to carry out a critical appraisal of their overall readiness to manage maternal cardiac arrest.…”

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confidence: 99%

“…6 Fait plus important encore, l'évacuation de l'utérus gravide augmente considérablement la probabilité de réussite de la réanimation maternelle, indépendamment de l'âge gestationnel. 2,7 Dans un cas de réanimation pendant lequel des compressions thoraciques bien réalisées ne produit pas de pouls maternel palpable, l'évacuation utérine doit être accélérée. En effet, le soulagement de la compression aorto-cave et l'effet d'autotransfusion pourraient potentiellement être très bénéfiques dans une tentative de réanimation maternelle.…”

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“…Ces observations correspondent à celles d'autres présentations de cas. 7,10 Non seulement les auteurs identifient-ils un problème de mauvaise documentation pour chacun des cinq cas d'arrêt cardiaque maternel, mais ils rapportent également les difficultés rencontrées dans l'organisation et la mobilisation de l'équipe pour procéder à l'accouchement par césarienne très urgent dans les quatre minutes suivant l'arrêt cardiaque. Plutôt que de conclure qu'il est peut-être acceptable de retarder la décision et le début de la chirurgie, d'autres leçons sont à tirer de cet article, notamment le besoin que nous tous, qui travaillons dans des centres offrant des services obstétricaux, nous évaluions notre degré de préparation générale à gérer un arrêt cardiaque maternel.…”

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Managing maternal cardiac arrest in Canada: – we’re doing OK, but we can do better

Preston

Campbell

2013

Can J Anesth/J Can Anesth

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Obstetric Life Support Education for Maternal Cardiac Arrest

Shields,

Vidosh,

Minard

et al. 2024

JAMA Netw Open

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ImportanceManagement of maternal cardiac arrest (MCA) requires understanding the unique physiology of pregnancy and modifications to life support. Health care professionals have historically demonstrated inadequate knowledge and skills necessary to treat MCA.ObjectiveTo evaluate the effect of Obstetric Life Support (OBLS) education on health care professionals’ cognitive performance, skills, and self-efficacy in managing MCA.Design, Setting, and ParticipantsIn this single-masked randomized clinical trial, 46 health care professionals, including emergency medical service and hospital staff representing diverse specialties, were randomized to intervention or control groups at a single academic medical center in Farmington, Connecticut between May 1, 2022, and July 23, 2023.InterventionThe intervention group received OBLS education, which included a blended learning curriculum with simulation-based training on common maternal medical emergencies that lead to MCA. Participants were assessed for knowledge, confidence, and skills (eg, megacode scores as team leaders during MCA simulations). Intervention participants were compared with control group participants who received no OBLS education.Main Outcomes and MeasuresThe primary outcome was cognitive scores. Secondary outcomes included megacode scores rated by experienced OBLS instructors masked to assignment groups, combined assessment pass rates, and cognitive and confidence scores at baseline and 6 and 12 months after education. Data were analyzed from January 2024 to May 2024.ResultsForty-six participants (mean [SD] age, 41.1 [16.2] years; 24 [52%] women) were randomized. Despite most participants holding certification in basic and advanced cardiac life support, significant between-group differences were identified in knowledge, skills, and confidence. Mean (SD) cognitive scores were 79.5% (9.4%) in the intervention group vs 63.4% (12.3%) in the control group (P &lt; .001). Mean (SD) megacode skills were higher in the intervention vs control group (91.0% [5.0%] vs 61.0% [12.0%], P &lt; .001), as were confidence scores (72.7 [13.3] vs 56.2 [17.9] points, P = .002). Combined assessment pass rates were 90% in the intervention group compared with 10% in the control group (P &lt; .001).Conclusions and RelevanceIn this randomized clinical trial, OBLS education significantly improved health care professionals’ knowledge, skills, and confidence in managing MCA. These findings underscore the urgent need for implementation of a standardized MCA curriculum nationwide, especially as the US continues to face unacceptably high maternal mortality rates.Trial RegistrationClinicalTrials.gov Identifier: NCT05355519

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Management of cardiac arrest in pregnancy: A systematic review

Cited by 84 publications

References 31 publications

Management of simulated maternal cardiac arrest by residents: didactic teaching versus electronic learning

Management of simulated maternal cardiac arrest by residents: didactic teaching versus electronic learning

Managing maternal cardiac arrest in Canada: – we’re doing OK, but we can do better

Obstetric Life Support Education for Maternal Cardiac Arrest

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