• Farida M Jeejeebhoy, Carolyn M Zelop, Rory Windrim, Jose C A Carvalho, Paul Dorian, and Laurie J Morrison.
• Department of Medicine, University of Toronto, Division of Cardiology, Mount Sinai Hospital, Toronto, ON, Canada. farida.j@sympatico.ca
• Resuscitation. 2011 Jul 1; 82 (7): 801-9.

ObjectiveTo describe the consensus on science pertaining to resuscitation of the pregnant patient.DesignSystematic review.Data SourcesEMBASE, Ovid MEDLINE, Evidence Based Reviews, American Heart Association library and bibliographies of selected articles.Review MethodsThe following inclusion criteria were used: pregnancy and cardiac arrest out of hospital, pregnancy and cardiac arrest in hospital, cardiovascular, respiratory, fetal survival, and pharmacology as they relate to cardiac arrest and resuscitation. Non-English papers, case reports and reviews were excluded. Studies were selected through an independent review of titles, abstracts and full article. Two reviewers independently graded the methodological quality of selected articles.Results1305 articles were identified and 5 were selected for further review. There were no randomized trials and overall the quality of the selected studies was good. Two studies examined chest compressions on a manikin in left lateral tilt from the horizontal and concluded that although feasible with increasing degrees of tilt forcefulness of the chest compressions decreases. The third study observed the transthoracic impedance was not altered during pregnancy. One case series and one retrospective cohort study reviewed perimortem cesarean section. Both reports concluded that perimortem cesarean section is rarely done within the recommended time frame of 5 min after the onset of maternal cardiac arrest.ConclusionsUsual defibrillation dosages are likely appropriate in pregnancy. Perimortem cesarean section is an intervention which is rarely done within 5 min to optimize maternal salvage from cardiac arrest. Chest compressions in left lateral tilt are less forceful compared to the supine position.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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