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Cardiac arrest in late pregnancy — DipIMC MCQ

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HardResuscitationCardiac arrest in late pregnancyDipIMC

A 34-year-old woman at 36 weeks' gestation collapses in a shopping centre. She is pulseless despite high-quality CPR, the uterus is above the umbilicus, and a critical care team is 8 minutes away. What is the most appropriate immediate action?

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

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Correct answer: B — Continue ALS with manual left uterine displacement and early perimortem caesarean planning

Maternal resuscitation follows ALS with effective chest compressions, defibrillation when indicated and aortocaval decompression by manual uterine displacement. Full lateral tilt can compromise compression quality. Perimortem caesarean delivery should be anticipated early when arrest persists beyond the first few minutes.

Reference: Resuscitation Council UK Special circumstances 2025; JRCALC maternity guidance