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February 25, 2022BMC Pregnancy and ChildbirthOpen Access

Effect of maternal positioning during cardiopulmonary resuscitation: a systematic review and meta-analyses

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Why the study?

Clinical guidelines emphasize maternal positioning during CPR due to aortocaval compression by the gravid uterus, but evidence regarding which position is most effective was limited.

Does the 27°-30° left-lateral tilt position improve the quality of chest compressions during maternal CPR compared to the supine position?

Population

Eight simulation-based crossover trials examining chest compression quality

Comparison

27°-30° left-lateral tilt position vs supine position

Design

Systematic review and meta-analyses

Authors

NENaosuke EnomotoTYTomoyuki YamashitaMFMarie Furuta

Discussion

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Overview

Left-lateral tilt yields inferior chest compression quality versus supine with manual displacement; challenges guideline positioning recommendations in pregnancy CPR.

Structured PICO

Does the 27°-30° left-lateral tilt position improve the quality of chest compressions during maternal CPR compared to the supine position?

P
Population
8 simulation-based crossover trials examining the quality of chest compressions during maternal cardiopulmonary resuscitation
I
Intervention
27°-30° left-lateral tilt position during cardiopulmonary resuscitation
C
Comparator
Supine position during cardiopulmonary resuscitation
O
Outcome
Quality of chest compressions (correct compression depth rate and correct hand position rate)surrogate

During maternal CPR, the supine position (with manual left uterine displacement) allows for higher quality chest compressions compared to the 27°-30° left-lateral tilt position.

Limitations

  • All included studies were simulation-based
  • No data available about survival rates of mothers or foetuses/neonates

Cite This Study

Enomoto et al. (2022) studied this question.

synapsesocial.com/papers/6a7426ff7be5820ec40a4ec1https://doi.org/10.1186/s12884-021-04334-y
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Also Consider

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  1. 1Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training?2010 · 218 citations
  2. 2Cardiac Arrest during Hospitalization for Delivery in the United States, 1998–20112014 · 219 citations
  3. 3Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions2019 · 7,213 citations
  4. 4Imputation methods for missing outcome data in meta-analysis of clinical trials2008 · 351 citations
  5. 5Maternal position during caesarean section for preventing maternal and neonatal complications2013 · 97 citations