Cardiopulmonary Arrest During Pregnancy: A Review Article

Area of Science:

• Obstetrics and Gynecology
• Cardiology
• Critical Care Medicine

Background:

• Massive pulmonary embolism (PE) is a severe, uncommon complication during pregnancy and the postpartum period.
• Maternal mortality rates have risen in the US, influenced by healthcare access, disparities, comorbidities, and ascertainment bias.
• Managing cardiac arrest in pregnant patients presents unique challenges due to physiological changes.

Purpose of the Study:

• To analyze available information on the management methods for massive pulmonary embolism (PE) in pregnancy.
• To review outcomes associated with PE and cardiac arrest in pregnant individuals.
• To highlight the importance of preparedness for maternal cardiac arrest.

Main Methods:

• Review of 127 cases of severe PE in pregnant or postpartum women who received treatment.
• Analysis of outcomes, including survival rates following thrombolysis.
• Discussion of interdisciplinary team approaches and advanced cardiac life support protocols for maternal cardiac arrest.

Main Results:

• Among 127 severe PE cases treated, 83 women received thrombolysis, achieving a 94% survival rate.
• Cardiac arrest occurred in 23% of severe PE cases.
• Hemorrhage and early delivery were significant outcomes impacting maternal and fetal survival.

Conclusions:

• Thrombolysis is an effective treatment for massive PE in pregnancy, associated with high survival rates.
• Preparedness for maternal cardiac arrest, involving interdisciplinary teams and specific protocols, is crucial given rising maternal mortality.
• Addressing socioeconomic factors and ensuring equitable healthcare access are vital for improving maternal outcomes.