Document Detail

Cardiopulmonary resuscitation and the parturient.
MedLine Citation:
PMID:  20418169     Owner:  NLM     Status:  MEDLINE    
Cardiopulmonary arrest occurs in 1: 30 000 pregnancies. Although rare, optimal outcomes are dependent on the cause of the arrest, the rapid response team's understanding of the physiological effects of pregnancy on the resuscitative efforts and application of the latest principles of advanced cardiac life support (ACLS). Anaesthesia-related complications, secondary to difficult or failed intubation, and inability to oxygenate and ventilate can result in adverse outcomes for mother and baby. Experience in advanced airway management has been shown to decrease the incidence of brain death and maternal mortality. Awareness of lipid resuscitation of local anaesthetic toxicity is important. The effects of lipid resuscitation and its interference with ACLS medications are also important. Peri-mortem caesarean delivery of the foetus greater than 24 weeks' gestational age must be considered. Caesarean delivery should be performed no later than 4min after initial maternal cardiac arrest. A foetus delivered within 5min has the best chance of survival. Delivery of the baby helps in the maternal resuscitation efforts and recovery of circulation. Finally, the 2003 International Liaison Committee on Resuscitation (ILCOR) and the 2005 American Heart Association (AHA) advocate the provision of mild therapeutic hypothermia to the survivors of cardiac arrest. This will improve the neurological outcomes by decreasing cerebral oxygen consumption, suppression of the radical reactions and reduction of intracellular acidosis and inhibition of excitatory neurotransmitters.
Maya S Suresh; Chawla LaToya Mason; Uma Munnur
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-04-24
Journal Detail:
Title:  Best practice & research. Clinical obstetrics & gynaecology     Volume:  24     ISSN:  1532-1932     ISO Abbreviation:  Best Pract Res Clin Obstet Gynaecol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-23     Completed Date:  2010-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101121582     Medline TA:  Best Pract Res Clin Obstet Gynaecol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  383-400     Citation Subset:  IM    
Copyright Information:
2010. Published by Elsevier Ltd.
Department of Anesthesiology, Baylor College of Medicine, Houston, TX 77030, USA. <>
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MeSH Terms
Advanced Cardiac Life Support / standards
Anesthesia, Obstetrical / adverse effects
Cardiopulmonary Resuscitation / methods*
Heart Arrest / etiology,  therapy*
Hospital Rapid Response Team*
Intubation, Intratracheal
Practice Guidelines as Topic
Pregnancy / physiology
Pregnancy Complications, Cardiovascular / etiology,  therapy*

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