Safety Considerations and Knowledge Gaps in Maternal Cardiopulmonary Resuscitation: A Systematic Review of Healthcare Professionals' Preparedness

Cardiopulmonary resuscitation (CPR) is a critical, life-saving intervention. In pregnant women, unique anatomical and physiological changes require adaptations to standard CPR protocols to ensure optimal outcomes for both mother and fetus, emphasizing the need for universal awareness and standardized training across diverse healthcare systems globally. Despite the high-risk nature of maternal cardiac arrest, evidence suggests that many healthcare professionals may not be adequately prepared to respond effectively. This systematic review followed PRISMA guidelines and included studies published between 2004 and 2024 identified through PubMed, Scopus, Web of Science, and Google Scholar. Boolean operators were used to combine keywords such as "cardiopulmonary resuscitation," "pregnancy," "knowledge," and "training." Studies assessing healthcare professionals' knowledge or training in maternal CPR were eligible, and seven cross-sectional studies conducted in hospital-based settings met the inclusion criteria. Findings across all studies revealed a consistent gap in knowledge among healthcare providers, including anesthesiologists, obstetricians, emergency physicians, midwives, and nurses. Common deficits included awareness of CPR modifications specific to pregnancy, drug dosing, maternal positioning, and perimortem cesarean protocols. Previous specialized training or real-world clinical exposure positively influenced knowledge levels. The results highlight the urgent need not only for standardized maternal CPR guidelines, but also for their global implementation through mandatory continuing education and simulation-based training. This approach aims to improve preparedness and clinical competence, ultimately enhancing outcomes for both mothers and newborns during cardiopulmonary emergencies.