Azadikhah Jahromi Sina, Ostovan Mina, Zahedi Razieh, Rahmanian Zhila, Abdollahzadeh Pegah
Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
Iran J Med Sci. 2025 Jun 1;50(6):363-375. doi: 10.30476/ijms.2024.104167.3767. eCollection 2025 Jun.
Targeted temperature management (TTM) is a standard care intervention following resuscitation, known to improve neurological outcomes in patients. However, there is a lack of comprehensive studies on the application of TTM, specifically therapeutic hypothermia, in pregnant patients. Considering the critical importance of maternal and fetal health, this study aimed to investigate the use of TTM in pregnant women following cardiac arrest.
This systematic review was conducted by searching multiple databases, including Web of Science, PubMed Central, MEDLINE, Scopus, EMBASE, and Cochrane, up to October 2024. The search was conducted with no restrictions on time, place, or language. Articles were selected based on predefined inclusion criteria, which included case reports detailing the use of TTM in pregnant women after cardiac arrest. The quality of the included studies was assessed using the Jonna Briggs Institute (JBI) checklist for case reports.
A total of nine articles met the inclusion criteria. Among the reported cases, there was 1 (11.1%) case of maternal death and 2 (22.2%) cases of fetal death, neither of which appeared to be directly attributable to the use of hypothermia. Neurological outcomes were favorable for all surviving mothers and fetuses following the application of TTM. The most common maternal complications during hypothermia for mothers were decreased blood pressure and heart rate, occurring in 2 (22.2%) cases. For the fetuses, bradycardia was the most frequently reported complication, occurring in 5 (55.5%) cases.
The use of TTM in pregnant patients following cardiac arrest might be considered on a case-by-case basis with the involvement of a multidisciplinary team. Pregnancy does not appear to be an absolute contraindication for TTM. However, close fetal monitoring is essential to ensure fetal well-being during the procedure.
目标温度管理（TTM）是复苏后的一项标准护理干预措施，已知可改善患者的神经学预后。然而，关于TTM，特别是治疗性低温在孕妇中的应用，缺乏全面的研究。考虑到母婴健康的至关重要性，本研究旨在调查心脏骤停后孕妇使用TTM的情况。
本系统评价通过检索多个数据库进行，包括科学网、PubMed Central、MEDLINE、Scopus、EMBASE和Cochrane，检索截至2024年10月。检索在时间、地点或语言上没有限制。根据预先定义的纳入标准选择文章，这些标准包括详细描述心脏骤停后孕妇使用TTM的病例报告。使用乔娜·布里格斯研究所（JBI）病例报告清单评估纳入研究的质量。
共有9篇文章符合纳入标准。在报告的病例中，有1例（11.1%）产妇死亡，2例（22.2%）胎儿死亡，两者似乎均与低温治疗的使用无直接关联。应用TTM后，所有存活的母亲和胎儿的神经学预后良好。母亲低温治疗期间最常见的产妇并发症是血压和心率下降，发生在2例（22.2%）。对于胎儿，心动过缓是最常报告的并发症，发生在5例（55.5%）。
心脏骤停后孕妇使用TTM可在多学科团队参与的情况下逐案考虑。妊娠似乎不是TTM的绝对禁忌证。然而，密切监测胎儿对于确保手术过程中胎儿的健康至关重要。
