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. 2014 Apr;120(4):810-8.
doi: 10.1097/ALN.0000000000000159.

Cardiac arrest during hospitalization for delivery in the United States, 1998-2011

Jill M Mhyre  1 , Lawrence C Tsen, Sharon Einav, Elena V Kuklina, Lisa R Leffert, Brian T Bateman
Affiliations

Cardiac arrest during hospitalization for delivery in the United States, 1998-2011

Jill M Mhyre et al. Anesthesiology. 2014 Apr.

Abstract

Background: The objective of this analysis was to evaluate the frequency, distribution of potential etiologies, and survival rates of maternal cardiopulmonary arrest during the hospitalization for delivery in the United States.

Methods: By using data from the Nationwide Inpatient Sample during the years 1998 through 2011, the authors obtained weighted estimates of the number of U.S. hospitalizations for delivery complicated by maternal cardiac arrest. Clinical and demographic risk factors, potential etiologies, and outcomes were identified and compared in women with and without cardiac arrest. The authors tested for temporal trends in the occurrence and survival associated with maternal arrest.

Results: Cardiac arrest complicated 1 in 12,000 or 8.5 per 100,000 hospitalizations for delivery (99% CI, 7.7 to 9.3 per 100,000). The most common potential etiologies of arrest included hemorrhage, heart failure, amniotic fluid embolism, and sepsis. Among patients with cardiac arrest, 58.9% of patients (99% CI, 54.8 to 63.0%) survived to hospital discharge.

Conclusions: Approximately 1 in 12,000 hospitalizations for delivery is complicated by cardiac arrest, most frequently due to hemorrhage, heart failure, amniotic fluid embolism, or sepsis. Survival depends on the underlying etiology of arrest.

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Figures

Fig. 1
Fig. 1
The frequency per 100,000 deliveries of maternal cardiac arrest by year, the Nationwide Inpatient Sample 1998–2011. Error bars denote the 99% CI.
Fig. 2
Fig. 2
The frequency of survival to hospital discharge in delivery-associated cardiac arrest by year, the Nationwide Inpatient Sample 1998–2011. Error bars denote the 99% CI.
Fig. 3
Fig. 3
By annual hospital delivery volume, the (A) frequency per 100,000 deliveries of maternal cardiac arrest and (B) frequency of survival to hospital discharge from maternal cardiac arrest, the Nationwide Inpatient Sample 1998–2011. Error bars denote the 99% CI.
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