诊疗指南

2015 AHA科学声明:孕期心搏骤停

Cardiac Arrest in Pregnancy:A Scientific Statement From the American Heart Association
2015-10-27 16:59 发表评论

Cardiac arrest in pregnancy is one of the most challenging clinical scenarios. Although most features of resuscitating a pregnant woman are similar to standard adult resuscitation, several aspects and considerations are uniquely different. The most obvious difference is that there are 2 patients, the mother and the fetus. Caregivers must have a thorough understanding of maternal mortality to best prevent and treat cardiac arrest in pregnancy. Maternal mortality is defined as the death of a woman during pregnancy and up to 42 days after delivery or termination of pregnancy, provided that the cause of death is related to or aggravated by the pregnancy or its management. Recent data from the US Nationwide Inpatient Sample suggest that cardiac arrest occurs in 1:12000 admissions for delivery. Globally, 800 maternal deaths occur daily. Maternal mortality trends in the United States as reported by the Centers for Disease Control and Prevention from 1989 to 2009 have documented a steady increase from 7.2 deaths per 100000 live births in 1987 to 17.8 deaths per 100000 live births in 2009. However, maternal mortality rates are just a small representation of maternal critical events; maternal near-miss data should be considered. A maternal near miss is defined as “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy.” Data from the Netherlands show an incidence of maternal near miss of 1:141 in delivery wards. Among cases with severe maternal morbidity, there was an overall case fatality rate of 1:53.6 Knowledge deficits and poor resuscitation skills could be major contributors to poor outcomes once cardiac arrest has occurred. Despite these problems, recent data show that the rate of survival to hospital discharge after maternal cardiac arrest may be as high as 58.9%, far higher than most arrest populations, further justifying appropriate training and preparation for such events despite their rarity.

    
学科代码:心血管病学 妇产科学   关键词:心搏骤停 ,指南 爱思唯尔医学网, Elseviermed
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