Key result
Prehospital resuscitative hysterotomy requires pregnancy-specific adaptations and targeted team training to improve survival.
Why the study?
Management of out-of-hospital cardiac arrest in a pregnant patient is challenging, both logistically and emotionally.
Does prehospital resuscitative hysterotomy improve survival in pregnant patients with out-of-hospital cardiac arrest?
Does prehospital resuscitative hysterotomy improve survival in pregnant patients with out-of-hospital cardiac arrest?
Prehospital clinicians should train for resuscitative hysterotomy to maximize maternal and fetal survival during out-of-hospital cardiac arrest in pregnant patients.
Supports prehospital RH training consideration in pregnant OHCA; leaves open incidence and outcome data for prospective validation.
Management of out-of-hospital cardiac arrest (OHCA) in a pregnant patient is challenging, both logistically and emotionally. This review explores the adaptations to resuscitation in pregnancy; the indications and preparation for prehospital resuscitative hysterotomy (RH); the surgical procedure; and the post-procedure care. Prehospital clinicians should train for RH in their teams to maximise the chances of maternal and fetal survival. Further research is needed to understand the incidence of maternal OHCA, how we can improve the chain of survival and the duration of maternal cardiac arrest before RH becomes futile to inform future guidelines.
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Leech et al. (2025) conducted a review in Out-of-hospital cardiac arrest in pregnancy. Prehospital resuscitative hysterotomy was evaluated. Prehospital resuscitative hysterotomy requires specific adaptations to resuscitation in pregnancy, and prehospital teams should train for this procedure to maximize maternal and fetal survival.
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