CPR in pregnant women: complications and new studies
Corresponding author Dr. T. Ezri Head, Dept. of Anesthesia, Wolfson Medical Center, Holon 58100, Israel
In pregnant women, CA is complicated by the pathophysiological changes that occur during pregnancy, especially aortocaval compression. During CPR with closed chest massage in non-pregnant patients the maximal cardiac output approximates ≤ 30% of normal. In patients 20 weeks pregnant lying in the supine position, the cardiac output is further decreased. This implies that if these patients suffer CA when placed in the supine position, there will be practically no cardiac output at all despite a correctly performed. CPR Patients in advanced pregnancy also have a tendency for rapid development of hypoxemia and acidosis, a higher risk of pulmonary aspiration, and an increased incidence of difficult intubation as compared to the non-pregnant population. These changes are exaggerated by multiple pregnancy and obesity, all of which make the resuscitation.
Cardiac arrest in pregnancy is a rare encounter, considered to occur in 1:30,000 births. It may lead to perimortem cesarean delivery in order to save the mother and her infant.
“Five minutes is just about long enough, depending upon personal preference, to boil an egg and butter some toast. It is also the period of time during which obstetric care givers are expected to identify maternal cardiac arrest, initiate cardiopulmonary resuscitation and, if maternal cardiac output is not immediately restored, deliver the fetus by caesarean section”. This quotation is a quintessence of the complexity involved in providing high-quality medical care quickly and efficiently to the pregnant patient who suffers a cardiac arrest.
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Want to know more? Cardiopulmonary resuscitation of pregnant women has been the topic of a study published on “Resuscitation Journal” in March 31, 2015. Authors are Danya Bakhbakhi, Islam Gamaleldin, Dimitrios Siasakos. CLICK HERE FOR THE ARTICLE