Maternal cardiac arrest is a rare and complex process requiring pregnancy-specific responses and techniques. The goals of this study were to (1) identify, evaluate, and determine the most current best practices to treat this patient population and (2) establish a standardized set of guidelines to serve as a foundation for a future educational simulation-based curriculum. We used a three-step modified Delphi process to achieve consensus. Twenty-two healthcare experts from across North America agreed to participate in the expert panel. In round 1, 12 pregnancy-specific best practice statements were distributed to the expert panel. Panelists anonymously ranked these using a 7-point Likert scale and provided feedback. Round 2 consisted of a face-to-face consensus meeting where statements that had not already achieved consensus were discussed and then subsequently voted upon by the panelists. Through two rounds, we achieved consensus on nine evidence-based pregnancy-specific techniques to optimize response to maternal cardiac arrest. Round one resulted in one of the 12 best practice statements achieving consensus. Round two resulted in six of the remaining 12 gaining consensus. Best practice techniques involved use of point-of care ultrasound, resuscitative cesarean delivery, cardiopulmonary resuscitation techniques, and the use of extracorporeal cardiopulmonary resuscitation. The results of this study provide the foundation to develop an optimal, long-term strategy to treat cardiac arrest in pregnancy. We propose these nine priorities for standard practice, curricula, and guidelines to treat maternal cardiac arrest and hope they serve as a foundation for a future educational curriculum.

中文翻译：

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改进的德尔菲方法确定当前治疗进展，以制定孕产妇心脏骤停复苏计划

孕产妇心脏骤停是一种罕见且复杂的过程，需要针对妊娠的反应和技术。本研究的目标是 (1) 识别、评估和确定治疗该患者群体的最新最佳实践，以及 (2) 建立一套标准化指南，作为未来基于教育模拟的课程的基础。我们使用三步修改德尔菲流程来达成共识。来自北美各地的 22 名医疗保健专家同意参加专家小组。在第一轮中，向专家小组分发了 12 份针对怀孕的最佳实践声明。小组成员使用 7 点李克特量表对这些内容进行匿名排名并提供反馈。第二轮包括面对面的共识会议，对尚未达成共识的声明进行讨论，然后由小组成员进行投票。通过两轮，我们就九项基于证据的妊娠特异性技术达成了共识，以优化对孕产妇心脏骤停的反应。第一轮的结果是 12 项最佳实践声明中的一项达成了共识。第二轮会议中，剩下的 12 人中的 6 人达成了共识。最佳实践技术包括使用床旁超声、复苏性剖宫产、心肺复苏技术以及体外心肺复苏。这项研究的结果为制定治疗妊娠期心脏骤停的最佳长期策略奠定了基础。我们提出了治疗孕产妇心脏骤停的标准实践、课程和指南的九个优先事项，并希望它们成为未来教育课程的基础。