PALM DESERT, CALF. — Obstetricians, emergency physicians, and anesthesiologists may suffer significant knowledge gaps when it comes to resuscitation of women in labor, suggest survey results presented in poster form at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.
Faculty and residents in all three groups of specialists at Stanford (Calif.) University responded to an 11-question anonymous survey covering four critical knowledge areas concerning resuscitation after catastrophic events in labor that lead to cardiorespiratory arrest:
▸ Awareness of the need for left uterine displacement.
▸ Recall of specific standard advanced cardiac life support (ACLS) algorithms.
▸ Knowledge of pertinent maternal physiology.
▸ Awareness of the recommendation to perform C-section in women at more than 20 weeks' gestation after 5 minutes of unsuccessful resuscitation for cardiac arrest.
Among 74 respondents, anesthesiologists answered the most questions correctly (average 76%). They were also better informed than other specialists about relevant maternal physiology.
Emergency physicians scored highest on questions regarding ACLS algorithms, averaging 93% correct responses.
All three groups earned similar scores on questions relating to left uterine displacement during resuscitation and the 5-minute cesarean rule. However, the rate of correct responses to those questions was low, at 60%–75%, said Leslie C. Andes, M.D., of the Stanford department of anesthesiology, and her associates.
They recommended that residents in all three specialties be required to complete ACLS certification, with an emphasis on the special resuscitation needs of women in labor. Labor and delivery suites are not the only places in a hospital where pregnant women may need to be resuscitated, the investigators noted in the poster.