Maternal Cardiac Arrest: Current Resuscitation Strategies and the Emerging Role of Simulation-Based Training

Authors: Ridhima Sharma, Anu Kewlani, Chayanika Kutum, Lalit Gupta, Ripon Choudhary

DOI: 10.18231/j.ijca.12293.1760328874

Keywords: pregnancy,maternal mortality,emergencies,resuscitation,cardiac arrest

Abstract: Maternal resuscitation during the antenatal period represents a critical and complex clinical challenge, as it involves the simultaneous management of both maternal and foetal well-being. The rarity of maternal cardiac arrest (MCA) combined with physiological changes of pregnancy, such as altered haemodynamics and airway challenges, demands a rapid, coordinated, and skilled multidisciplinary response. Despite ongoing global efforts to reduce maternal mortality, the burden remains high, particularly in low- and middle-income countries. Preventable deaths due to maternal cardiac arrest (MCA) are frequently attributed to knowledge gaps and inadequate response times. In recognition of this, the American Heart Association (AHA) and other authorities have released pregnancy-specific resuscitation guidelines. Yet, adherence to these protocols in real-world practice remains uneven. Simulation-based training has emerged as a promising strategy to bridge this gap, offering clinicians the opportunity to practise rare, high-risk scenarios in a safe, controlled environment. This narrative review discusses the causes and pathophysiology of maternal cardiac arrest, evaluates existing resuscitation guidelines focusing on the AHA recommendations, and underscores the growing importance of simulation-based education in improving maternal and neonatal outcomes during cardiac emergencies in pregnancy.