Cardiopulmonary resuscitation and somatic support of the pregnant patient.
Cardiopulmonary arrest during pregnancy is a rare event that critical care clinicians must be prepared to manage. The causes of cardiopulmonary arrest during pregnancy, recommended modifications to cardiopulmonary resuscitation protocols that are specific to pregnancy, indications for and timing of perimortem cesarean delivery, and the expected fetal outcomes are reviewed. Rarely, brain death of a pregnant patient may occur in which continued support of the mother is possible to prolong the pregnancy and improve fetal outcome. Prolonged somatic support of pregnant patients who are brain dead presents specific management challenges, but has been accomplished. The physiologic changes that occur after brain death and recommendations for somatic support of the brain dead pregnant patient also are reviewed.
Mallampalli
Antara
A
Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Ben Taub General Hospital, 1504 Taub Loop, 6th Floor, Houston, TX 77030, USA. antara@bcm.tmc.edu
Powner
David J
DJ
Gardner
Michael O
MO
D001926:Brain Death; D016887:Cardiopulmonary Resuscitation; D002585:Cesarean Section / Q000379:methods; D004992:Ethics, Medical; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D008020:Life Support Care / Q000379:methods*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000628:therapy; D011256:Pregnancy Outcome