We describe 3 cases of maternal cardiogenic cardiac arrest with survival within a 3 year period.
The first case occurred in a 38 year old primiparous woman with no risk factors throughout the pregnancy. She had a spontaneous normal vaginal delivery at term but went into hypotensive collapse the day after delivery. She had a cardiac arrest from which she was successfully resuscitated. She underwent a coronary artery bypass graft some days later. Retrospectively she admitted to having had a diagnosis of hypercholesterolaemia.
The second case occurred in a 43 year old P8 woman at 32/40. She had been diagnosed in to have cardiomyopathy in the index pregnancy. She arrested in CCU where she had been admitted for observation and care. She had a perimortem Caesarean Section on the floor of CCU. The mother and baby survived.
The third case was of a 37 year old P2 who was a heavy smoker with a history of hypercholesterolaemia and CVA. She had a myocardial infaction at 19/40 for which a percutaneous stent was inserted. She had a VF arrest from which she was successfully resuscitated. She went on to have a successful normal vaginal delivery.
This case series of serious cardiac morbidity reflects the national trend of an increase in indirect deaths from cardiac disease. This is now the leading cause of death from all causes.
Should maternity units now be including cardiac arrest skills drills on their training?
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