Cardiac Arrest in Pregnant Women Rare but Serious

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Cardiac arrest during childbirth more likely among pregnant women over 35 and tied to other complications

March 19, 2014 / Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

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(dailyRx News) While women and doctors do their best to avoid complications during pregnancy, they can still occur, and some of these complications are more common than others. Even the rare ones — like cardiac arrest — can be serious.

A new study looked at rates of cardiac arrest among women before and after childbirth throughout the US during 1998 to 2011.

The researchers found that cardiac arrest was more likely to occur in women over 35, and was commonly associated with other complications during delivery, like excessive blood loss.

"Eat a balanced diet to help keep your heart healthy."

In cardiac arrest, the heart suddenly stops working and beating as it should, and death can quickly occur.

The authors of this new study, which was led by Jill M. Mhyre, MD, of the Department of Anesthesiology at the University of Michigan Health System in Ann Arbor, aimed to explore rates of maternal cardiac arrest occurring before or after child birth.

To do so, Dr. Mhyre and team used data from the Nationwide Inpatient Sample from 1998 to 2011 to look for hospitalizations for child deliveries that were complicated by maternal cardiac arrest.

Of the over 56 million hospitalizations for delivery examined during this time, 4,843 cases of cardiac arrest occurred.

The researchers then estimated that cardiac arrest was a complication in one in 12,000 delivery hospitalizations, or 8.5 per 100,000 delivery hospitalizations, in the US during 1998 to 2011.

The women who had cardiac arrest during delivery were more likely to be 35 or older, non-Hispanic black and have Medicaid health insurance versus private insurance.

Overall, among women who experienced these cardiac arrests, 59 percent lived until they were discharged from the hospital. As the study period went on, survival rates seemed to improve a little each year.

In around 74 percent of cases, another condition that could have possibly led to or complicated cardiac arrest was also reported.

Dr. Mhyre and team found that the most common medical complication in the mother associated with cardiac arrest was hemorrhage, or excessive loss of blood, which occurred in 38.1 percent of cases.

Other common conditions included heart failure, sepsis (a severe reaction to infection) and amniotic fluid embolism, which occurs when the fluid that surrounds the baby in the womb gets into the mother's bloodstream.

Cardiac arrest was not necessarily caused by these complications in all cases. Further research is needed to learn more about potential causes of maternal cardiac arrest.

"Cardiac arrest, or heart attacks, in pregnant women fortunately occur very rarely," Andre Hall, MD, an OBGYN at Birth and Women's Care, PA in Fayetteville, NC, told dailyRx News.

"The fact that most women who get pregnant are young significantly decreases the likelihood of a cardiac arrest as this is a condition usually reserved for middle aged and elderly adults. However, the additional stress of pregnancy, and the 50 percent increase in blood volume can be the tipping point for a woman with a weakened cardiovascular system," said Dr. Hall, who was not involved in this study.

"Therefore, women of all ages should exercise, eat a healthy diet, and limit stressors in hopes of preventing this rare but potentially life threatening condition," he said.

“These are rare high-stakes events on obstetric units, and team preparation is critical to ensure that everyone is ready to act quickly and effectively,” said Dr. Mhyre in a press release from the American Society of Anesthesiologists. “Fortunately, physician anesthesiologists are experts in leading resuscitation teams for maternal cardiac arrest and other emergencies that happen on the labor floor.”

This study was published in the April issue of the journal Anesthesiology. No conflicts of interest were reported.