Safe Motherhood after Cardiopulmonary Resuscitation in a Term Pregnancy with Eclampsia: A Maternal Near Miss

Abstract

Cardiac arrest in a term pregnancy is rare with a survival rate of 15-20% and mortality rate as high as 42%. Eclampsia, amniotic fluid embolism, haemorrhagic shock, sepsis, pulmonary thromboembolic events, and anaesthetic complications are significant causes of cardiac arrest. We report a rarest case of a young 26-year-old unbooked primigravida, 38+4 weeks gestation with eclampsia, HELLP syndrome, thrombocytopenia with sudden cardiac arrest-A Maternal Near Miss. Prompt resuscitation with obstetric, and anaesthetist specialist team, paved the journey to safe motherhood. An emergency Lower Segment Caesarean Section (LSCS) immediately after Cardiopulmonary Resuscitation (CPR) was performed. Ventilator support was continued for 72 hours. Successful CPR and immediate caesarean section paved the way to safe motherhood with discharge of healthy mother and baby on 12th post LSCS day. With increasing trends towards high-risk pregnancy and maternal near miss cases, a thorough knowledge in the management of cardiac arrest in pregnancy with advanced resuscitation skills among obstetricians, anaesthetists, and nursing staff is need of the millennium. Repeated simulation learning and mock drills in CPR in pregnancy should be advocated.

Keywords

• caesarean section
• cardiac arrest
• cardiopulmonary resuscitation