The Resus Room

Maternal Arrest; Roadside to Resus

55 snips
Feb 12, 2025
Caroline Leech, an Emergency Medicine and Prehospital doctor, shares her expertise on maternal cardiac arrests, a rare but critical situation affecting mothers and their unborn babies. She discusses the physiological changes during pregnancy that complicate resuscitation efforts. Insights from her recent paper on Resuscitative Hysterotomy challenge the conventional survival expectations for both mother and child. Caroline emphasizes the need for effective teamwork, communication, and training to prepare for these high-stakes emergencies while navigating the emotional toll on responders.
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INSIGHT

Maternal Arrest Overview

  • Maternal cardiac arrest is rare, affecting 1 in 12-30,000 women in developed countries.
  • It presents unique resuscitation challenges due to physiological changes and the presence of two patients.
INSIGHT

Physiological Changes in Pregnancy

  • A gravid uterus at 20 weeks reduces venous return, impacting CPR effectiveness.
  • Maternal hypoxia and shock reduce fetal oxygen delivery.
ADVICE

Uterine Displacement

  • Manually displace the uterus to the patient's left side during CPR in arrests after 20 weeks gestation.
  • Prioritize manual displacement over wedges or tilted CPR.
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