UMEM Educational Pearls

Category: Cardiology

Title: 2010 AHA Guidelines: cardiac arrest in pregnancy

Keywords: pregnancy, cardiac arrest, compressions (PubMed Search)

Posted: 11/28/2010 by Amal Mattu, MD (Updated: 1/26/2022)
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In the second half of pregancy, we've traditionally learned that the gravid uterus compresses the inferior vena cava and therefore decreases cardiac output when patient is in a supine position. Therefore, we've learned that patients in the second half of pregnancy the patient should be placed in a left lateral tilt position.

However, it is difficult to perform good quality chest compressions when the patient is in a titled position.

Therefore, the optimal position for chest compressions on the patient in cardiac arrest in the second half of pregnancy is to have the patient in a supine position; and have another rescuer manually deflect the uterus to the patient's left side. This provides optimal compressions + optimal venous return.

References

Vanden Hoek TL, Morrison LJ, Shuster M, et al. Part 12: cardiac arrest in special situations. 2010 American Heart Association Guidelines for cardiopulmonary resuscitaiton and emergency cardiovascular care. Circulation 2010;122[suppl 3]:S829-S861.