Update: Focus in-hospital maternal cardiac arrest
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TL;DR: A salvage cesarean delivery must be performed immediately, without transfer to the operating room, if resuscitation maneuvers have failed 4 min after arrest, because this interval conditions the mother's neurological prognosis and improves neonatal survival.
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Abstract: The incidence of maternal cardiac arrest ranges from 1/55,000 to 1/12,000 births. It is due most frequently to cardiovascular, hemorrhagic, and anesthesia-related causes, as well as to amniotic fluid embolism. The basic principles of resuscitation remain applicable in this situation, but the physiological modifications of pregnancy must be taken into account, in particular, the aortocaval compression syndrome. After 24 weeks of gestation, a salvage cesarean delivery must be performed immediately, without transfer to the operating room, if resuscitation maneuvers have failed 4 min after arrest, because this interval conditions the mother's neurological prognosis and improves neonatal survival.
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Citations
The association of obstetric anesthesiologists, India – An expert committee consensus statement and recommendations for the management of maternal cardiac arrest
Sunil T Pandya,Kajal Jain,Anju Grewal,Ketan Parikh,Karuna Sharma,Anjeleena K. Gupta,Shilpa Kasodekar,Aruna Parameswari,Daisy Gogoi,Lalit Kumar Raiger,Gonibeed Rao Ravindra,Sunanda Gupta,Anjan Trikha +12 more
TL;DR: This consensus statement was prepared by the experts after reviewing evidence-based literature on maternal resuscitation during MCA and found teamwork is critical to success in the high-stakes environment of MCA.
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Arrêt cardio-respiratoire au cours de l’accouchement
Nouhad Ayoub,Agnès Le Gouez +1 more
TL;DR: In this article, the authors propose a demarche etiologique doit etre entreprise en parallele, and a cesarienne dite perimortem doit andre pratiquee dans le temps du massage cardiaque pour en augmenter l-efficacite en levant notamment la compression cave and preserver les chances de survie du fœtus.
Prise en charge d’un état de choc en cours de grossesse
TL;DR: In obstetrique, les causes of choc sont les mêmes que celles des décès maternels : cardiopathie, embolies amniotique et pulmonaire, hémorragie du post-partum, sepsis (pour les plus fréquentes) as discussed by the authors .
Guidelines for the management of urgent obstetric situations in emergency medicine, 2022.
G. Bagou,Loïc Sentilhes,Frédéric J. Mercier,Paul Berveiller,Julie Blanc,Eric Cesareo,Pierre-Yves Dewandre,Bénédicte Douai,Aurélie Gloaguen,Max Gonzalez,Philippe Le Conte,Agnès Le Gouez,Hugo Madar,Emeline Maisonneuve,Estelle Morau,T. Rackelboom,Mathias Rossignol,Jeanne Sibiude,Julien Vaux,Alexandre J. Vivanti,Sybille Goddet,Patrick Rozenberg,Marc Garnier,Anthony Chauvin +23 more
TL;DR: In this article , a group of 24 experts from the French Society of Emergency Medicine (SFMU), the French society of Anaesthesia and Intensive care medicine (SFAR) and the French College of Gynaecologists and Obstetricians (CNGOF) was convened to provide recommendations on the management of urgent obstetrical emergencies outside the maternity ward.
References
Why Mothers Die — Report on Confidential Enquiries into Maternal Deaths in the United Kingdom 1994–96
J. A. Crowhurst,F. Plaat +1 more
TL;DR: This is the fifteenth Report in this series on maternal deaths and is the fourth reporting on deaths in the UK as a whole, with an increase in the absolute numbers of Direct and Indirect deaths in this triennium.
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TL;DR: In this paper, a review of the past centuries' cases and fetal physiology suggest that to obtain optimum infant survival, cesarean delivery should be initiated within four minutes of maternal cardiac arrest.
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Perimortem cesarean delivery: were our assumptions correct?
TL;DR: In this article, the outcomes of perimortem cesarean deliveries were reviewed to validate the assumption that cardiopulmonary resuscitation is ineffective in the third trimester because of aortocaval compression, and fetal and perhaps maternal outcomes would be optimized by timely delivery.
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Cardiac arrest in pregnancy: Increasing use of perimortem caesarean section due to emergency skills training?
A. Dijkman,C. M. A. Huisman,M. Smit,Joke M. Schutte,J.J. Zwart,J. J. van Roosmalen,J. J. van Roosmalen,Dick Oepkes +7 more
TL;DR: Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training?
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Cardiac Arrest during Hospitalization for Delivery in the United States, 1998–2011
TL;DR: Approximately 1 in 12,000 hospitalizations for delivery is complicated by cardiac arrest, most frequently due to hemorrhage, heart failure, amniotic fluid embolism, or sepsis, which depends on the underlying etiology of arrest.
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