MATERNAL CARDIAC ARREST (MCA), EMERGENCY RESPONSE & PERIMORTEM CESAREAN SECTION (PMSC) Asma Ansari 1, Shehla Baqai 2 1 Armed Forces Institute of Cardiology & National Institute of Heart Diseases 2 Army Medical College, Military Hospital Rawalpindi INTRODUCTION METHODOLOGY RESULTS Total number of patients n = 15 100% patients received ACLS Place of MCS was labor room for 5 (33%) patients Apparent cause of MCA amniotic fluid embolism 7(46%) Maternal mortality 73.3%, Neonatal mortality 64.3% Timings of PCMS is strongly associated with survival Maternal Cardiac Arrest is the most complex arrest scenario, as there are two patients mother and fetus MCA is rare, reportedly occurring in 1 in 30,000 pregnancies Current American Heart Association and Royal College of Gynaecologists guidelines recommend slight modifications Most important modification is PMCS within in 5 minutes of MCA to facilitate maternal resuscitation in gestation of > 20 weeks of pregnancy Retrospective analysis of hospital records from Jan 2010 to Dec 2015 Inclusion Criteria: All pregnant patients diagnosed with cardiac arrest treated with chest compressions and provision of ACLS and PMCS Exclusion Criteria: Patients < 20 weeks gestation, out of hospital cardiac arrest and maternal return of spontaneous circulation within 4 minutes Chi square test was applied to find association between groups CONCLUSION RESULTS Best hope of fetal survival is maternal survival Maternal resuscitation training should be given to all Health Care Professionals Early recognition, immediate CPR with recourse to PMCS within 5 minutes saves lives Table 1: Maternal characteristics of study population Characteristics (Mean ± SD) Values 1 Mean Age 34.4 ± 5.2 years 2 Mean gestational age 35.33 ± 2.02 weeks 3 Mean interval before PMCS 19.07 ± 6.1 minutes FUTURE IMPLICATIONS First case series reported in Pakistan All emergency departments and Obstetric units to keep required data for further prospective studies. Resuscitation guidelines and PMCS equipment available at ER and labor room Figure 2: Maternal and neonatal survival after PMCS Figure 1: American Heart Association guidelines for MCA REFERENCES OBJECTIVES 2010 American Heart Association guidelines for CPR and Emergency cardiovascular care. RCOG. Maternal collapse in pregnancy and Puerperium. Green Top guidelines no. 56. 2011 Einav S et al. Maternal cardiac arrest and perimortem caesarean delivery: evidence or expert-based?. Resuscitation. 2012 Oct 31;83(10):1191-200. To determine outcome of MCA To establish association of PMCS timing with maternal & neonatal survival