中国中西医结合急救杂志2025，Vol.32Issue(3)：316-320,5.DOI:10.3969/j.issn.1008-9691.2025.03.011
孕产妇心搏骤停的临床特点及预警要点剖析
Analysis of clinical characteristics and early warning points of maternal cardiac arrest
摘要
Abstract
Objective To analyze the clinical manifestations and diagnostic characteristics of maternal cardiac arrest(MCA)patients,summarize warning symptoms,and provide a basis for the prevention,early identification,and intervention of this event.Methods A retrospective study was conducted.Clinical data of 15 pregnant or postpartum women who experienced cardiac arrest or were transferred to Peking University Third Hospital due to cardiac arrest from January 2012 to December 2023 were collected,including age,comorbidities,causes of MCA,warning symptoms,parameters related to cardiopulmonary resuscitation(CPR,such as time and location of cardiac arrest,initial heart rhythm,electrical defibrillation,medication use,duration of CPR,restoration of spontaneous circulation,and etc.),parameters related to perimortem cesarean delivery(time interval between fetal delivery and cardiac arrest,delivery of infants),clinical outcomes(such as cerebral performance category,length of hospital stay),and multidisciplinary treatment.The main clinical endpoint was patient survival at discharge.The clinical and diagnostic characteristics of MCA were descriptively analyzed,and compare the differences in age,duration of CPR,shockable rhythm,proportion of patients with cardiac arrest occurring prenatally,and length of hospital stay among patients with different prognoses of MCA.Results The median age of 15 MCA patients was 31(30,33)years.A total of 10 cases(66.7%)of patients had concurrent obstetric diseases.Six cases(40.0%)of patients had MCA due to postpartum hemorrhage,which was the most common cause,followed by acute heart failure[2 cases(13.3%)]and pulmonary embolism[2 cases(13.3%)].A total of 12 cases(80.0%)of MCA patients showed obvious warning symptoms before cardiac arrest,with the most common warning symptoms including dyspnea(3 cases,20.0%),consciousness disorders(3 cases,20.0%),and vaginal bleeding(3 cases,20.0%).A total of 12 cases(80.0%)of MCA occurred in late pregnancy.All 15 MCA events occurred within the hospital,with an average of 5(4-6)departments involved in the CPR process.Four patients(26.7%)had an initial heart rhythm of ventricular fibrillation and all received defibrillation therapy,9 patients(75.0%)were treated with adrenaline.Two patients who were over 20 weeks pregnant underwent manual left uterine thrusting intervention during CPR,and both patients were successfully discharged.A total of 12 patients(80.0%)received CPR,of which 7 patients(58.3%)were discharged with good neurological function.A total of 11 patients underwent cesarean section surgery,and the survival rate of fetuses delivered by cesarean section was 83.3%.The duration of CPR in survivors was significantly shorter than that in deceased patients[minutes:7.0(2.0,23.3)vs.144.0(90.0,190.5),P<0.05].Conclusion Postpartum hemorrhage is the most common cause of MCA,and after active treatment,over 50%of patients can achieve good neurological function and be discharged.Comprehensive and effective CPR,strengthened coordination among multidisciplinary teams,and early identification and warning of symptoms are key strategies for improving the prognosis of MCA patients.关键词
孕产妇/心搏骤停/临床特点/预警Key words
Maternal/Cardiac arrest/Clinical characteristics/Early warning引用本文复制引用
王军红,宋瑶,徐晨,张莉萍,魏瑗,马青变..孕产妇心搏骤停的临床特点及预警要点剖析[J].中国中西医结合急救杂志,2025,32(3):316-320,5.基金项目
国家临床重点转科建设项目(2022)专项资金(301-2305) （2022）
北京大学第三医院院队列建设项目(BYSYDL2021008) National Key Clinical Specialty Construction Project(2022)Special Fund(301-2305) （BYSYDL2021008）
Peking University Third Hospital Cohort Construction Project(BYSYDL2021008) （BYSYDL2021008）
