Aim

To describe a cohort of pregnant women having suffered an out-of-hospital cardiac arrest (OHCA) and to compare them with nonpregnant women of childbearing age having suffered OHCA.

Methods

Study data were extracted from the French National OHCA Registry between 2011 and 2021. We compared patients in terms of characteristics, care and survival.

Results

We included 3,645 women of childbearing age (15-44) who had suffered an OHCA; 55 of the women were pregnant. Pregnant women were younger than nonpregnant victims (30 vs. 35 years, p=0.006) and were more likely to have a medical history (76.4% vs. 50.5%, p<0.001) and a medical cause of the OHCA (85.5% vs. 57.2%, p<0.001). Advanced Life Support was more frequently administered to pregnant women (98.2%, vs. 72.0%; p<0.001). In pregnant women, the median time of MICU arrival was 20 minutes for the Medical Intensive Care Unit with no difference with nonpregnant women. Survival rate on admission to hospital was higher among pregnant women (43.6% vs. 27.3%; p=0.009). There was no difference in 30-day survival between pregnant and nonpregnant groups (14.5% vs. 7.3%; p=0.061). Fetal survival was only observed for OHCAs that occurred during the pregnancy second or third trimester (survival rates: 10.0% and 23.5%, respectively).

Conclusions

Our results show that resuscitation performance does not meet European Resuscitation Council’s specific guidelines on OHCA in pregnant women. Although OHCA in pregnancy is rare, the associated prognosis is poor for both woman and fetus. Preventive measures should be reinforced, especially when pregnant women have medical history.

中文翻译：

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孕妇院外心脏骤停：一项 55 名患者的法国队列研究

目标

描述一组患有院外心脏骤停 (OHCA) 的孕妇，并将她们与患有 OHCA 的育龄妇女进行比较。

方法

研究数据提取自 2011 年至 2021 年间法国国家 OHCA 登记处。我们比较了患者的特征、护理和生存率。

结果

我们纳入了 3,645 名患有 OHCA 的育龄妇女（15-44 岁）；其中55名妇女怀孕。孕妇比未怀孕的受害者年轻（30 岁对 35 岁，p=0.006），更有可能有病史（76.4% 对 50.5%，p<0.001）和 OHCA 的医学原因（85.5% 对. 57.2%，p<0.001)。高级生命支持更频繁地用于孕妇（98.2% 对 72.0%；p<0.001）。在孕妇中，重症监护病房到达 MICU 的中位时间为 20 分钟，与非孕妇没有差异。孕妇入院时的存活率较高（43.6% vs. 27.3%；p=0.009）。妊娠组和非妊娠组之间的 30 天生存率没有差异（14.5% 对 7.3%；p=0.061）。

结论

我们的结果表明，复苏表现不符合欧洲复苏委员会关于孕妇 OHCA 的具体指南。尽管妊娠期 OHCA 很少见，但相关的预后对女性和胎儿都很差。应加强预防措施，尤其是有病史的孕妇。