Online CPR Certification Blog
CPR on a Pregnant Woman: A Step-By-Step Guide
Date: November 19th, 2022
Steps to Perform CPR on a Pregnant Woman
In an SCA emergency, it’s important to administer lifesaving first aid to the victim. That’s why it’s so crucial to know how to perform CPR on a pregnant woman.
Remember, both the mom and unborn baby are at risk, so you need to respondas soon as possible. Read on to discover more:
How Common is Maternal Cardiac Arrest?
In the United States, maternal cardiac arrest accounts for less than one percent of all pregnancy-related deaths. The condition is considered a serious complication of pregnancy and childbirth.
According to the American College of Obstetricians and Gynecologists (ACOG), there are approximately 750,000 live births in the U.S. each year; that’s about 4 million births per decade.
The rate of maternal mortality (death) during pregnancy or within six weeks after delivery is about 23 per 100,000 live births (or 2 per 1,000). This includes both direct and indirect causes of death associated with pregnancy and childbirth.
How is CPR on a Pregnant Woman Different?
While CPR is effective in all people, including pregnant women, it’s important to note that performing CPR on a pregnant woman is different from CPR performed on non-pregnant individuals. One of these differences is in how you issue chest compressions.
First, you want to make sure you’re using two hands during chest compressions when dealing with a pregnant woman; for one thing, an extra hand can provide stability so that you can achieve proper depth and speed of compressions.
Chest compressions should also be shallower than the two inches for non-pregnant women; remember that there’s another person inside your patient. Doing deeper compressions could cause too much pressure to reach her baby during delivery.
Another difference between CPR on pregnant women and non-pregnant patients is that if the cardiac arrest is due to pregnancycomplications (such as preeclampsia), you’ll need to deliver oxygen through a mask or bag valve mask instead of mouth-to-mouth resuscitation. The rest of basic CPR remains unchanged.
Special Considerations Before Performing CPR on a Pregnant Woman
Before beginning CPR, check for any potential danger signs that could indicate that it’s not safe to perform chest compressions.
For example, if you notice fluid coming out of her mouth or nose and she isn’t coughing, she may have an obstructed airway. In these cases, do initial ventilations before doing chest compressions.
If there is an obstruction in her airway (e.g., vomit), gently roll her onto one side and give five back blows and then five abdominal thrusts before starting CPR with mouth-to-mouth resuscitation if appropriate.
If she’s not breathing, start chest compressions at a rate of 100 per minute. If she’s pregnant with twins or triplets, use two hands for compressions instead of 1 hand to ensure adequate force.
Use your free hand to check for a pulse every 30 seconds during chest compressions.
Continue until EMS arrives or you feel confident that she has recovered.
Instructions for Performing Chest Compressions on a Pregnant Woman
If you’re performing CPR on a pregnant woman, move her to her left side. Be sure to have someone call 911 so that paramedics can transport her to an emergency room.
While waiting for them to arrive, administer chest compressions by positioning yourself above your patient and aligning your sternum with her spine.
Begin issuing chest compressions– about 100 times per minute for five minutes–or until paramedics arrive.
When performing CPR on a pregnant woman who is not breathing or has difficulty breathing, check to make sure she has an airway obstruction before beginning chest compressions.
If she does have an obstacle, clear it by using your hands to open her airway by tilting her chin forward while tilting her head back at a 45-degree angle with your thumbs underneath her jawline.
Once there is no longer an obstruction, begin chest compressions while waiting for someone with proper CPR first aid training.
Instructions for Mouth-to-mouth Resuscitation
To give rescue breaths, lean over and cover your mouth with your hands.
Place your lips slightly more than one inch away from their mouth and take two quick breaths. Check to see if they’re breathing and if not, repeat until they start breathing on their own. Then turn to chest compressions immediately without giving any more rescue breaths.
To perform CPR, place one hand on top of the other in between their breasts. Press down at least 2 inches deep for 30 compressions; keep going until help arrives or someone with proper training takes over.
Can You Use an AED on a Pregnant Woman?
In a recent study, the survival rate for out-of-hospital cardiac arrest patients jumped from 8% to 20% after using an automated external defibrillator (AED).
While this was an amazing improvement, it also raises questions about using AEDs on pregnant women. Is it safe to use an AED on a pregnant woman? And if so, what are the risks?
The answer is yes and no. AEDs can be used on pregnant women with a heart attack or other types of cardiac arrest. But some concerns go along with this decision.
It’s important to know that there isn’t much information about how well AEDs work on pregnant women or how effective they may be in saving lives and preventing brain damage. In fact, there have been very few studies done on this topic at all — just a handful over the last decade or two.
The main issue is that most research studies don’t include pregnant women because they’re considered high risk during pregnancy and labor due to complications such as bleeding and infection.
So when researchers do test AED devices on people with cardiac arrest, they typically include only men or non-pregnant women in their studies.
AHA Guidelines on AED use for Maternal Cardiac Arrest
According to AHA, there is no evidence that using an AED on an expectant woman will harm the baby.
The American Heart Association (AHA) has issued a statement saying that there is no evidence that using an AED on a pregnant woman will harm the baby. The AHA also says that if someone is in cardiac arrest, you should use the AED.
According to the AHA:
“There is no evidence that using an automated external defibrillator (AED) on an expectant woman will harm her fetus.”
“If there are signs of life, begin CPR immediately. If there are no signs of life, use the AED and follow directions for performing chest compressions.”
CPR on a Pregnant Woman: What Causes Maternal Cardiac Arrest?
Maternal cardiac arrest is a severe but rare complication of pregnancy. It occurs when the mother’s heart stops beating, and she stops breathing.
The mother may also have other symptoms, including pain, numbness or tingling in her hands or feet; weakness or dizziness; confusion; and vomiting.
A maternal SCA is a rare event. In the United States, it accounts for less than 1 percent of all pregnancy-related deaths.
The most common cause of cardiac arrest in women is pregnancy-related complications such as preeclampsia and eclampsia, but there are many other causes, including heart attack and stroke.
Common Causes of Maternal Cardiac Arrest
Other times, it may be related to:
- A previous heart condition that goes undetected until you are pregnant
- A recent infection or injury, such as surgery or physical trauma (such as a car accident)
- Cardiac arrest due to sepsis – This is the most common cause of cardiac arrest in pregnant women. It accounts for about half of all cases.
- Cardiac arrest due to hemorrhage – This accounts for about one-third of cases.
- Cardiac arrest due to pulmonary embolism (PE) – This is rare but can occur if you have a clot in your lungs or blood vessels.
- Preeclampsia — which is condition that begins after 20 weeks of pregnancy and causes high blood pressure and protein in the urine.
- Eclampsia —which is a more severe form of preeclampsia that also causes seizures.
- Heart valve problems or heart rhythm disturbances (arrhythmias).
- A blood clot in a vein deep inside your body may cause a stroke (embolism).
It may also be linked to cancer treatment like chemotherapy or radiation therapy that can damage the heart muscle over time.
Final Words on CPR on a Pregnant Woman
Maternal cardiac arrest can happen at any time during pregnancy or childbirth. But it’s more likely to occur during labor and delivery, immediately after birth, or within 24 hours of delivery.
Each year in the United States, about 15 out of every 100,000 women experience maternal SCA during labor and delivery. That number jumps to about 25 per 100,000 for mothers who’ve already given birth once before.
Maternal cardiac arrest can be treated successfully if it’s diagnosed early enough