Review of cardiopulmonary resuscitation in pregnant Women

Document Type : Original Article

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Abstract

Introduction: Cardiopulmonary resuscitation is a critical performance in pregnant women, and if it is done correctly mother and fetus will be rescued. Anatomic and physiologic changes in pregnancy should be considered. The fetus increases the oxygen demand and carbon dioxide production, so the function of cardiopulmonary system increases and consequently cardiac output, heart rate, minute ventilation, tidal volume and respiratory rate increase.
 
In airway management, since the respiratory tract is fragile and edematous, in applying supportive devices occurrence of hemorrhage and more edema should be considered. In breathing support we should avoid the increase or decrease of ventilation, since changes in Co2 and PH decreases placental perfusion. Because of pendulous breast and diaphragm heightening, cardiac massage should be done in the middle of sternum. Drugs are contraindicated in pregnancy, but tratogenicity should be afforded.
 
Conclusion: Finally, after five minutes if CPR was not successful cesarean section should be done, since it is an effective factor in better resuscitation of mother and will improve the survival and neurological state of infant.
 
 

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References

1. Kloeck W, Cammins Ro,Chamberlain D, et al.Special resuscitation ; an advisory
statement from the international liaison committee on resuscitation. Circul 1997;95
:2196-2210.
2. Lee RV, Rodgers BD, White LM ,et al. Cardiopulmonary resuscitation of pregnant
women. Am J Med 1986; 81:311- 318.
3. Didly GA, Clark SL.Cardiac arrest during pregnancy .Dbstet Gynecol Clin North
Am 1995; 22: 303-314.
4. Department of Health, Welsh Office, Scottish Office Department of Health,
Department of Health and Social Services, Northern Ireland. Why mothers die.
Report on confidential enquiries into maternal deaths in the United Kingdom 2000–
2002. London, England: The Stationery Office; 2004.
5. Lee W.Pregnanc - induced physiologic alterations. In: Clark SL,cotton DB,Hankins
GDV,et al,eds.Critical cire obstetnis *,3rded. Malden: black well science ;1997.3-32.
6. Archer GW, Marx Gls*. Arterial oxygen tension during opnea in parturient women.
Br Anesth 1974; 46:358-360.
7. Stain AJ, Cardiopulmonary resuscitation. In: Clark SL, Cotton DB, Hankins
CDV,et al, eds. Critical care scirnce Obsterrics , 3rd ed. Malden : Blackwell Science
, 1997:219-237.
8. Selden Bs, Burke TJ. Complete materual and fetel recovery after prolonged cardiac
arrest. Am Emerg Med 1988; 17: 346-349.
9. Page-Rodriguez A, Gonzalez-Sanchez JA. Perimortem cesarean section of twin
pregnancy: case report and review of the literature. Acad Emerg Med. 1999; 6:
1072–1074.
10. Cardosi RJ, Porter KB.Cesarean delivery of twins during maternal cardiopulmonary
arrest. Obstet Gynecol. 1998; 92: 695–697.
11. Johnson MD, Luppi CJ, Over DC. Cardiopulmonary Resuscitation. In: Gambling
DR, Douglas MJ, eds. Obstetric Anesthesia and Uncommon Disorders.
Philadelphia: WB Saunders; 1998. 51–74.
12. American Heart Association. Special resuscitation situation. In: Textbook of advanced
cardiac life support. Dallas: American Heart Assoiation; 1997.11-7-11-19.
13. Morris S, Stacey M. Resuscitation in pregnancy. BMJ. 2003; 327: 1277–1279
14. Rees GAD, Willis BA. Resuscitation in late pregnancy. Anesthesia 1992; 47: 433-434.
15. Good win APL, Pearce AJ. The human wedge. Aneasthesia 1992; 47: 433-434.
16. Nanson J, Elcock D, Williams M, Deakin CD. Do physiological changes in pregnancy
change defibrillation energy requirements? Br J Anaesth. 2001; 87: 237–239.
17. Dean –Wiggins L. Emergency childbirth. In: Roberts JR, Hedges JR , eds. Clinical
procedures in emergency medical , 3rd ed. Philadelphia: WB saunders; 1998.988-1015
18. Katz VL, Dotters DJ, Droegemuller W.Perimovtem cesarean delivery. Obstet
Gynecol 1986;68 :517-76. 
 
19. Gianopoulos JG.Emergency complication of labor & delivery. Emerg Med Clin
North Am 1994; 12:201-217
20. Boyd R, Teece S. Towards evidence based emergency medicine: best BETs from
the Manchester Royal Infirmary. Perimortem caesarean section. Emerg Med J.
2002; 19: 324–325
21. American Heart Association Guidelines for Cardiopulmonary Resuscitation and
Emergency cardiovascular Care 2005: Cardiac arrest associated with pregnancy.
Circul 2005; 112: IV -150.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 10, Issue 2 - Serial Number 2
September 2008
Pages 87-96

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