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

Abstract

25% of cardiac arrest in pregnancy is caused by anaesthesia. Rapid perimortem section improves survival.

Care of Women with Obesity in Pregnancy

“…A study of UK Obstetric Surveillance System data showed that one‐quarter of maternal cardiac arrests were related to anaesthesia. Of this number, 75% of the women were obese . Epidural resite rate in the women with class III obesity (greater than 136 kg in weight) was 17% in a cohort study compared with 3% in the control group (less than 113 kg in weight) .…”

Maternal Collapse in Pregnancy and the Puerperium

“…In addition, women with mechanical prosthetic heart valves are at particularly increased risk of complications in pregnancy . These women should be cared for by an appropriately skilled and experienced multidisciplinary team, usually in regional centres . Other cardiac causes include: cardiomyopathy; dissection of the coronary artery; acute left ventricular failure; infective endocarditis; and pulmonary oedema.Evidence level 2 + +…”

“…The majority of deaths secondary to cardiac causes occur in women with no previous history, 2,3 and almost one in five deaths occurred in an ambulance or accident and emergency department. 2,38 Therefore, paramedics and accident and emergency staff must be familiar with the management of maternal collapse. The main cardiac causes of maternal death are ischaemia and sudden arrhythmic cardiac death with a structurally normal heart.…”

“…Even when it is, it is not collected in a standardised way to facilitate comparisons . The incidence of cardiac arrest in pregnancy is much rarer than maternal collapse at around 1 in 36 000 maternities, with a case fatality rate of 42%. In a UK study, a total of 25% of cardiac arrests in pregnancy were secondary to anaesthesia and all were associated with a 100% survival rate …”

“…In a UK study, a total of 25% of cardiac arrests in pregnancy were secondary to anaesthesia and all were associated with a 100% survival rate. 2 It is accepted that lessons can be learned from severe morbidity and near misses, and MBRRACE-UK now undertake targeted maternal morbidity confidential enquiries. 3 The UK Obstetric Surveillance System (UKOSS), run by the National Perinatal Epidemiology Unit, has made a significant contribution towards the study of rare events and maternal morbidity.…”