Start the CPR
A woman collapses, is unresponsive and is only gasping. Should you start CPR?
Yes. Gasping is abnormal breathing. Activate the emergency response, start CPR and get an AED/defibrillator.
During CPR, in which direction should the pregnant uterus be manually displaced?
Towards the woman’s left.
What equipment should someone bring urgently to identify and treat a shockable rhythm?
An AED or defibrillator.
A woman has a massive postpartum haemorrhage and then arrests. Which reversible cause should you strongly suspect?
Hypovolaemia from blood loss.
What compression-to-ventilation ratio is used for an adult before an advanced airway is established?
30 compressions to 2 breaths.
When does ANZCOR suggest manual uterine displacement during maternal cardiac arrest?
When pregnancy is over 20 weeks, or the uterus is palpable above the umbilicus.
Which two cardiac arrest rhythms are shockable?
Ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT).
Name three possible causes of maternal cardiac arrest other than haemorrhage.
Any three: cardiac disease, pulmonary embolism, sepsis, hypertensive disorders, amniotic fluid embolism, anaphylaxis, drug toxicity or trauma.
What are the recommended chest compression rate and depth for an adult?
100–120 compressions per minute, to a depth of at least 5 cm, avoiding excessive depth. Allow full chest recoil.
Why does manually displacing the uterus help maternal resuscitation?
It relieves aortocaval compression, improving venous return and supporting circulation during CPR.
What should you normally do immediately after delivering a shock?
Immediately resume CPR, beginning with compressions, for approximately two minutes before the next scheduled rhythm assessment.
Why can a pregnant woman become hypoxic more quickly, and what does this mean for the resuscitation team?
Pregnancy increases oxygen consumption and reduces lung oxygen reserves. Provide effective oxygenation and ventilation and summon expert airway help early.
Another rescuer is ready to take over compressions. When should you change compressors, and how should you do this?
Approximately every two minutes, or sooner if fatigued. Coordinate the change to minimise interruptions.
A colleague says, “We must always tilt the woman during CPR.” Explain the recommended approach.
Use manual left uterine displacement, with the woman supine to facilitate compressions. ANZCOR allows added left lateral tilt only if high-quality compressions and access for surgical delivery can be maintained.
The monitor shows organised electrical activity, but there is no detectable cardiac output. Name the rhythm and state whether it should be shocked.
Pulseless electrical activity (PEA). Do not shock. Continue CPR and the non-shockable ALS pathway while identifying and treating reversible causes.
A woman at 32 weeks remains in cardiac arrest despite resuscitation. What urgent obstetric intervention should the expert team consider, and how can it help the mother?
Resuscitative hysterotomy / perimortem caesarean delivery. Emptying the uterus relieves aortocaval compression and may improve maternal resuscitation. Prepare urgently while CPR continues.