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Decoding Code OB: A National Survey of Obstetrical Emergency Codes.

Jamie Reardon1, Sarah Blissett2, Ariela Jamshidi-Shahvar3

  • 1Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS.

Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|January 22, 2026
PubMed
Summary
This summary is machine-generated.

Maternal cardiac arrest response protocols are inconsistently implemented across Canada. Most hospitals use general emergency codes, not unique ones, highlighting a need for standardized, researched maternal arrest guidelines to improve patient outcomes.

Keywords:
hospital rapid response teammaternal mortalityobstetrics

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Area of Science:

  • Obstetrics and Gynecology
  • Emergency Medicine
  • Health Systems Research

Background:

  • Maternal cardiac arrest has a high fatality rate, necessitating effective emergency response protocols.
  • International guidelines suggest unique codes for maternal cardiac arrest, but implementation guidance is lacking.
  • Canadian data on maternal cardiac arrest response is limited, hindering national improvement efforts.

Purpose of the Study:

  • To map the variety of obstetrical emergency codes and team responses currently used in Canadian teaching hospitals.
  • To identify the extent of implementation of unique or composite codes for maternal cardiac arrest.

Main Methods:

  • A survey of 28 of 32 Canadian teaching hospitals (excluding Quebec) with obstetrical beds.
  • Extraction of data on obstetrical emergency codes, response details, and evaluation from public documents or key informants.
  • Categorization of codes as composite (multiple emergencies), combined (merged codes), or dedicated (single emergency).

Main Results:

  • 50% of surveyed hospitals utilize at least one obstetrical emergency code, primarily for time-critical events.
  • Only 21% (6/28) of hospitals have codes that include maternal cardiac arrest (3 composite, 3 combined).
  • A unique, dedicated maternal arrest code was found in only one hospital.

Conclusions:

  • Dedicated maternal cardiac arrest codes, despite guideline recommendations, are rarely used in Canadian teaching hospitals.
  • The prevalent use of composite or combined codes for maternal arrest lacks proven safety and efficacy.
  • There is a significant national opportunity to standardize and research in-hospital maternal arrest protocols to enhance patient outcomes.