The clinical categories associated with cardiac arrest in pregnancy include:
1) advanced cardiovascular disorders, such as complex congenital heart defects, especially with Eisenmenger’s physiology, primary pulmonary hypertension, and other forms of heart disease associated with chronic heart failure
2) less severe cardiovascular disorders, such as mild to moderate valvular heart disease, predominantly obstructive, in the absence of heart failure
3) unrecognized cardiovascular disorders in which there is no forewarning
4) aortic dissection
5) complications of pregnancy, such as preeclampsia/eclampsia and hypertension
6) cardiac arrest secondary to anesthesia complications during labor and delivery
7) amniotic fluid embolism
8) pulmonary embolism
9) certain drug toxicities.
In pregnancy, myocardial infarction is the most prevalent cause of cardiac arrest owing to either early atherosclerosis or coronary artery dissection. In part, this is due to a rise in the number of women having pregnancies beyond the age of 35. Myocardial infarction’s paradoxical age- and gender-related occurrence puts risk in the category of previously unknown cardiac illness, giving it a special challenge for prediction and prevention. Complex congenital heart illnesses are the second most prevalent cause of cardiovascular disease, with aneurysms/dissections taking a third place. Pregnant women in this group have a high risk of cardiac arrest and mortality during the latter stages of pregnancy and delivery. Those with cyanotic congenital cardiac disease, a resting O2 saturation of less than 85 percent on room air, and/or severe pulmonary hypertension are at the greatest risk of death. In certain subgroups, the maternal death rate might be as high as 30%. Doctors have advised these women to avoid conception or to terminate an unplanned pregnancy in the first trimester if they so want because of this substantial maternal cardiac arrest and death risk.
