Resucitación cardiopulmonar y cerebral en la embarazada: Al final del colapso materno

摘要

Objective: To provide healthcare professionals involved in the management of complications in pregnancy (including obstetricians, nurses, general and emergency practitioners, anaesthetists, critical care physicians) with the fundamental principles for the prevention and management of cardiopulmonary arrest in this population group in order to improve outcomes for both the mother and the newborn. Materials and methods: A search was conducted in the Medline, SciELO and Embase databases using the terms "Cardiopulmonary Resuscitation, Pregnancy, Perimortem Caesarean, Maternal Cardiac Arrest, Cardiac arrest in pregnancy", restricted to the following types of publications: "Meta-analysis, Systematic Reviews, Practice Guideline, Randomized Controlled Trial, Review, Case Report, Chapter, Editorial, Survey". Results: Of 78 titles found overall, 63 were included. Of these, 22 were narrative reviews, 20 case reports and case series, 8 practice guidelines, 5 clinical trials, 4 editorials, 2 systematic reviews or meta-analyses, 1 book chapter and 1 survey. Conclusions: Cardiac arrest in pregnant women poses a challenge to the interdisciplinary team managing the case because it may be associated with a high degree of maternal and perinatal morbidity and mortality. The main steps required are: obstetric blue code activation with appropriate response for performing timely emergent hysterotomy; good-quality chest compressions; manual uterine displacement 15o to the left when the pregnant uterus is palpated above the maternal umbilicus; advanced pharmacological and airway management; and optimal care after resuscitation for both the mother and the neonate.