Resuscitation in pregnant women - the current international guidelines under close scrutiny

The management of cardiac arrest in pregnant women requires adjustments to account for the physiology of pregnancy, the specific causes of cardiac arrest, and the potential need for a resuscitative delivery if a return of spontaneous circulation cannot be achieved. Successful resuscitation hinges upon the prompt availability and stringent coordination of a multidisciplinary specialized team. Resuscitation measures are often compromised by delays in initiating interventions (uterine lateralization; high-quality, minimally interrupted cardiopulmonary resus-citation; dealing with potentially difficult airways; resuscitative cesarean delivery). Resuscitative cesarean delivery is one of the rarest, yet physically and emotionally demanding procedures in dealing with obstetric emergencies potentially leading to the birth of a viable newborn infant in need of resuscitation itself. Timely access to the resources and personnel capable of coordinating this multidisciplinary endeavor varies based on the local environment. Therefore, unequivocal treatment recommendations are of paramount clinical importance. Despite broad consensus, differences between the current recommendations released October 2025 by the American Heart Association (AHA) and the European Resuscitation Council Guidelines (ERC) may cause confusion. Clinical implementation therefore remains a challenge, particularly when resuscitation takes place outside a hospital and/or in the absence of a trained team. The complexity of this clinical scenario underscores the need for teams to prepare and train for these rare emergency situations.