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Cardiac arrest is cessation of heart action. Ventricular standstill (asystole) and ventricular fibrillation are the immediate causes, but the underlying etiologies are most frequently acute myocardial hypoxia or alteration in conduction or both. In obstetrics and gynecology, cardiac arrest occurs during induction of anesthesia and during operative surgery or instrumented delivery. Cardiovascular disease increases the risk of cardiac arrest, and hypoxia and hypertension are contributory causes. Cardiac arrest may follow shock, hypoventilation, airway obstruction, excessive anesthesia, drug administration or drug sensitivity, vasovagal reflex activity, myocardial infarction, air and amniotic fluid embolism, and heart block. . | MEDICAL AND SURGICAL COMPLICATIONS DURING PREGNANCY CARDIOVASCULAR DISEASES CARDIAC ARREST Cardiac arrest is cessation of heart action. Ventricular standstill asystole and ventricular fibrillation are the immediate causes but the underlying etiologies are most frequently acute myocardial hypoxia or alteration in conduction or both. In obstetrics and gynecology cardiac arrest occurs during induction of anesthesia and during operative surgery or instrumented delivery. Cardiovascular disease increases the risk of cardiac arrest and hypoxia and hypertension are contributory causes. Cardiac arrest may follow shock hypoventilation airway obstruction excessive anesthesia drug administration or drug sensitivity vasovagal reflex activity myocardial infarction air and amniotic fluid embolism and heart block. Cardiac arrest occurs in 1 800 to 1 1000 operations and is apt to occur during minor surgical procedures as well as during major surgery. It occurs in 1 10 000 obstetric deliveries usually operative complicated cases. Fortunately it is possible to save at least 75 of patients when cardiac arrest occurs in the well-managed and well-equipped operating or delivery room. CARDIOPULMONARY RESUSCITATION CPR CPR is used for treatment of asphyxia or cardiac arrest Fig. 15-1 . Phase I First Aid Emergency Oxygenation of the Brain Basic life support must be instituted within 3-4 min for optimal effectiveness and to minimize permanent brain damage. Do not wait 423 Copyright 2001 The McGraw-Hill Companies. Click Here for Terms ofUse. 424 BENSON PERNOLL S HANDBOOK OF OBSTETRICS AND GYNECOLOGY 1 Open airway by positioning neck anteriorly in extension. Inserts show airway obstructed when the neck is in resting flexed position and opening when neck is extended. 2 Rescuer should close victim s nose with fingers seal mouth around victim s mouth and deliver breath by vigorous expiration. 3 Victim is allowed to exhale passively by unsealing mouth and nose. Rescuer should listen and feel for .
