Maternal Cardiac Arrest
For expecting mothers – inundated with concerns such as pregnancy loss, preeclampsia, or gestational diabetes – maternal cardiac arrest is probably what they least anticipate. Although many pregnant women may not encounter such a complication, it is still plenty threatening.
What is Cardiac Arrest and Why is it Dangerous?
Cardiac arrest occurs when the heart stops beating properly. Consequently, the heart is no longer able to deliver oxygen-rich blood to the brain and other vital organs.
Without oxygen, a person in cardiac arrest is clinically dead, and will remain so, unless they receive treatment immediately. While high-quality CPR can artificially keep the blood pumping, an AED machine is needed to restart the heart. By delivering a defibrillation “shock” to a person in cardiac arrest, an AED can make the heart start beating normally again. Every minute that a person in sudden cardiac arrest does not receive a shock from an AED defibrillator, their chances of survival decrease by 7-10%.
Pregnant women are particularly vulnerable to oxygen deprivation caused by cardiac arrest. During pregnancy, the fetus requires significant amounts of oxygen from the mother. In fact, women experience a 20% increase in oxygen consumption and a 40% increase in cardiovascular metabolism to accommodate the fetus. Altered levels of hormones like progesterone and estrogen during pregnancy can also restrict air passages and exacerbate the dangers associated with maternal cardiac arrest. These physiological changes, in combination, make cardiac arrest an especially life-threatening condition in pregnant women. Therefore, when pregnant women suffer from sudden cardiac arrest, it is critical to perform high-quality CPR with rescue breaths and use an AED immediately.
Maternal Mortality is Increasing in the United States
According to an AJOG report, “while the global maternal mortality ratio (maternal deaths/100,000 live births) has decreased in the last 25 years from 281.5- 95.7, the maternal mortality ratio has actually increased from 16.9- 26.4 in the United States.”
As Dr. Carolyn Zelop, a leading maternal-fetal medicine specialist, states, “maternal mortality has gone up by more than 50% since 2000.”
Given this increase in maternal mortality, the AJOG report calls for mandating maternal CPR to improve the survival of pregnant women in hospital settings.
Outside of the hospital, pregnant women who suffer cardiac arrest also need CPR and treatment from an AED machine. Women are already 27% less likely than men to receive CPR outside of the hospital. These known disparities suggest that pregnant women likely receive even less bystander CPR because responders are plausibly concerned about inflicting harm. Therefore, it is critical to stress the importance of both CPR and life-saving shocks from an AED for pregnant women who suffer cardiac arrest.
How Common is Maternal Cardiac Arrest?
Although maternal cardiac arrest is more rare than some pregnancy-related conditions, it still affects a large number of women in the United States and globally.
An American Heart Association report, on which Dr. Zelop is the second author, paints a grim picture. The report details that 1 in 12,000 women admitted for delivery in the United States suffer from sudden cardiac arrest.
The overall number of women affected by this condition is likely larger due to maternal arrests that occur outside the hospital. Additionally, many hospitals in the United States lack systems for reporting maternal cardiac arrest incidents.