Division of Cardiology, William Osler Health System, and Division of Cardiology, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto M5G1Z5, Canada.
Division of Maternal Fetal Medicine, Mount Sinai Hospital Toronto and Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto, Toronto, Canada.
Best Pract Res Clin Obstet Gynaecol. 2014 May;28(4):607-18. doi: 10.1016/j.bpobgyn.2014.03.006. Epub 2014 Mar 29.
Cardiac arrest in pregnancy is a rare event in routine obstetric practice, but is increasing in frequency. Resuscitation of cardiac arrest is more complex for pregnant women because of a number of factors unique to pregnancy: the altered physiologic state induced by pregnancy; the requirement to consider both maternal and fetal issues during resuscitation; and the consequent possibility of perimortem caesarean section during resuscitation. These extra considerations create a unique clinical emergency and decision pathway requiring the co-ordinated response of medical, obstetric, and neonatal teams. Although many research questions remain in this area, recent consensus has been reached on appropriate resuscitation of a pregnant woman. Centres offering care for birthing women need to be aware of the changing demographics and resuscitation guidelines in this important area, and implement measures to ensure dependable and optimal team responses to maternal cardiac arrest.
妊娠中的心搏骤停在常规产科实践中是一种罕见事件，但发生率正在增加。由于妊娠的一些特有因素，孕妇的心搏骤停复苏更为复杂：妊娠引起的生理状态改变；复苏期间需要同时考虑母婴问题；以及复苏期间可能需要进行围产死亡剖宫产。这些额外的考虑因素创造了独特的临床紧急情况和决策途径，需要医疗、产科和新生儿团队的协调应对。尽管在这一领域仍有许多研究问题，但最近已就适当的孕妇复苏达成共识。提供分娩妇女护理的中心需要意识到这一重要领域的人口统计学和复苏指南的变化，并采取措施确保对产妇心搏骤停做出可靠和最佳的团队反应。
