AHA Scientific Statement

1747 Abstract—This is the first scientific statement from the American Heart Association on maternal resuscitation. This document will provide readers with up-to-date and comprehensive information, guidelines, and recommendations for all aspects of maternal resuscitation. Maternal resuscitation is an acute event that involves many subspecialties and allied health providers; this document will be relevant to all healthcare providers who are involved in resuscitation and specifically maternal resuscitation. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest. Expert peer review of AHA Scientific Statements is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit http://my.americanheart.org/statements and select the " Policies and Development " link. C ardiac arrest in pregnancy is one of the most challenging clinical scenarios. Although most features of resuscitating a pregnant woman are similar to standard adult resuscitation, several aspects and considerations are uniquely different. The most obvious difference is that there are 2 patients, the mother and the fetus. Caregivers must have a thorough understanding of maternal mortality to best prevent and treat cardiac arrest in pregnancy. Maternal mortality is defined as the death of a woman during pregnancy and up to 42 days after delivery or termination of pregnancy, provided that the cause of death is related to or aggravated by the pregnancy or its management. Recent data from the US Nationwide Inpatient Sample suggest that cardiac arrest occurs in 1:12 000 admissions for delivery. Maternal mortality trends in the United States as reported by the Centers for Disease Control and Prevention from 1989 to 2009 have documented a steady increase from 7.2 deaths per 100 000 live births in 1987 to 17.8 deaths per 100 000 live births in 2009. 4 However, maternal mortality rates are just a small representation of maternal critical events; maternal near-miss data should be considered. A maternal near miss is defined as " a woman who nearly died but survived a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy. " 5 Data from the Netherlands …