Baris Cankaya
Marmara University Hospital, Turkey
Title: Causes of cardiac arrest in pregnant and performing effective cardiopulmonary resuscitation according to the 2015 guidelinerements and thromboembolic risk markers assessed by echocardiography in patients with non valvular atrial fibrillation: a cross-sectional study
Biography
Biography: Baris Cankaya
Abstract
Women experience physiologic changes during pregnancy which make clinicians focus on both the pregnant and the newborn with a specialized topic. There are some reasons why cardiopulmonary resuscitation is more difficult to perform and leading to less effective management in the pregnant than in the non-pregnant. Some changes associated with pregnancy are cardiovascular changes (increased heart rate, increased stroke volume, increased cardiac output, decreased systemic vascular resistance, increased uterine blood flow), respiratory changes (increased respiratory rate, increased oxygen consumption, decreased functional residual capacity, decreased bronchial tonus, increased upper airway vascularity), increased renal blood flow, increased cortisol, aldosterone, ACTH and insulin levels, decreased albumin, increased sedation, shift of oxy-Hgb dissociation curve to right and increased plasma volume. At term, the vena cava is completely occluded in 90% of supine positioned pregnant patients and the stroke volume may be only 30% of that of a non-pregnant woman. During cardiac arrest, avoiding for the effects of the gravid uterus on venous return, a maternal pelvic tilt to the left of greater than 15 degrees is recommended. The tilt needs to be less than 30 degrees for effective closed chest compression. Delivery of the fetus during cardiac arrest will reduce the oxygen demands on the mother and also increase the venous return to the heart. The esophageal sphincter is more relaxed during pregnancy, so entrance of air into the stomach is increased. Passive regurgitation of stomach contents which are greater in volume and more acidic in pregnancy can damage the lungs. The need for cardiopulmonary resuscitation (CPR) is a rare event occurring in one out of 30,000 pregnancies. Cardiac disease remains the leading cause of death in pregnancy. Physiological changes that occur in pregnancy, including the overall increase in circulatory volume status, may contribute to improved survival in pregnant women having non-traumatic
