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Maternal cardiac arrest — DipIMC MCQ

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HardResuscitationMaternal cardiac arrestDipIMC

A 34-week pregnant patient remains in cardiac arrest after initial ALS with manual left uterine displacement. A skilled obstetric team is present and there is no ROSC. Which time-critical intervention should now be prepared at the arrest site?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Perform resuscitative hysterotomy as soon as the team is ready

The best answer is “Perform resuscitative hysterotomy as soon as the team is ready”. Above 20 weeks, aortocaval compression must be relieved throughout resuscitation and preparation for resuscitative hysterotomy should begin early. RCUK 2025 emphasises performing it as soon as possible at the site of arrest by a skilled team rather than delaying for transport or an arbitrary elapsed time. Maternal resuscitation remains the primary purpose.

Reference: Resuscitation Council UK 2025, Special circumstances: https://www.resus.org.uk/professional-library/2025-resuscitation-guidelines/special-circumstances-guidelines