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Perioperative cardiac arrest in obstetric patients
M Astete1, H J Lacassie2, A Gálvez3
1Hospital Clínico Dr. Lautaro Navarro Avaria, Punta Arenas, Chile.
None:
Perioperative cardiopulmonary arrest (CPA) in the obstetric patient is a rare but devastating complication, representing a significant clinical challenge due to the speed with which it threatens the lives of the mother and fetus. Although, compared to the general population, obstetric patients have a lower risk due to their youth and fewer comorbidities, recent records show an increase in the incidence of CPA in this group. Anesthetic factors are key, especially when general anesthesia is used, and unexpected conversion from neuraxial blocks poses an additional risk. Success in the management of CPA critically depends on early recognition and a coordinated, structured approach, where understanding the causes and maternal physiology is essential. Emphasizing education specifically dedicated to obstetric CPA is a priority, as conventional approaches like basic and advanced cardiac life support have proven insufficient for the particularities of this setting. To optimize outcomes, it is recommended to train skilled multidisciplinary teams, implement adapted protocols, and carry out timely interventions such as perimortem cesarean section. Effective communication between teams and the application of advanced support measures, always considering maternal and fetal well-being, are decisive factors for prognosis. In summary, perioperative CPA in obstetrics requires specific protocols, ongoing knowledge updates and simulation, with the primary goal of reducing maternal mortality and improving neonatal outcomes in one of the most critical scenarios faced by healthcare teams.
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