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Cardiopulmonary Resuscitation in Pregnant Patients: Ensuring Maternal and Fetal Survival



Cardiopulmonary Resuscitation in Pregnant Patients: Ensuring Maternal and Fetal Survival

Introduction:

Cardiopulmonary resuscitation (CPR) in pregnant patients presents unique challenges that require a specialized approach. The goal is to ensure the safety and well-being of both the mother and the fetus. In this blog post, we will explore the key considerations and strategies for performing CPR in pregnant patients.

Etiology of Cardiac Arrest and Maternal Mortality:

The causes of maternal cardiac arrest vary, with pre-existing diseases, cardiovascular issues, infections, and hemorrhage being common culprits. The rates and aetiologies of maternal mortality differ between regions, highlighting the importance of tailored approaches to resuscitation. Survival rates depend on the underlying cause of cardiac arrest, with resuscitative efforts yielding better outcomes in cases related to anesthesia complications.

Critical Steps in CPR:

CPR in pregnant patients follows the standard protocols with specific modifications. Chest compressions should be firm, deep (at least 5 cm), and fast (100 compressions per minute). Left uterine displacement is crucial to optimize venous return and can be performed manually. Airway management should address physiological changes in pregnancy, such as increased oxygen consumption and potential difficulties in intubation. Intravenous access should be obtained above the diaphragm, and drugs should be administered following standard guidelines.

Team Preparedness and Transesophageal Echocardiography:

Preparation and regular review of response plans by a multidisciplinary team are vital for effective CPR. Closed-loop communication, strong leadership, and teamwork enhance the resuscitation process. Transoesophageal echocardiography can aid in identifying the cause of cardiac arrest and assessing the effectiveness of resuscitative efforts, facilitating better decision-making during the critical moments.

ECMO CPR and Post-Resuscitation Care:

Extracorporeal membrane oxygenation (ECMO) can be a valuable tool in stabilizing critically ill pregnant patients. ECMO CPR, when available, has been shown to improve outcomes. Post-resuscitation care should involve appropriate surgical interventions, haemostasis management, and intensive care protocols, with attention to maternal hypothermia and coagulopathy.

Conclusion:

CPR in pregnant patients requires a specialized and coordinated approach to optimize outcomes for both the mother and the fetus. By adhering to specific techniques, ensuring team preparedness, and utilizing available technologies such as transoesophageal echocardiography and ECMO, we can improve the chances of maternal and fetal survival during cardiac arrest events. Through ongoing research and advancements in resuscitation strategies, we strive to enhance the care provided to pregnant patients in critical situations. #CPR #Pregnancy #MaternalHealth #EmergencyMedicine #Resuscitation

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807943/