Evidence map›Paper›PMID 42271244›Full record

SynthesisBMC cardiovascular disorders2026

Advanced resuscitation strategies for cardiac arrest in pregnancy: a systematic review.

Takashi Hongo, Tetsuya Yumoto, Takafumi Obara, Tomohiro Hiraoka, Yoshinori Kosaki, Shunta Jinno, Ippei Matsuo, Misa Sasanami, Yuya Miyoshi, Shodai Yoshihiro and 3 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Takashi HongoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Tetsuya YumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Takafumi ObaraDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Tomohiro HiraokaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Yoshinori KosakiDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Shunta JinnoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Ippei MatsuoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Misa SasanamiDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Yuya MiyoshiDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Shodai YoshihiroDepartment of Pharmaceutical Services, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan.
Takahiro TsugeDepartment of Rehabilitation, Kurashiki Medical Center, 250 Bakuro, Kurashiki, Okayama, 710-8522, Japan.
Atsunori NakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan.
Hiromichi NaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata, Kita, Okayama, 700-8558, Japan. naito.hiromichi@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac arrest during pregnancy is a rare, life-threatening event. The roles of resuscitative delivery (RD) and extracorporeal cardiopulmonary resuscitation (ECPR) remain unclear. This systematic review summarizes maternal and neonatal outcomes according to initial resuscitation strategy.

methodsThis systematic review followed a preplanned protocol registered in the Open Science Framework and adhered to PRISMA guidelines. MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi were searched from inception to May 8, 2025, without language restrictions. Cases were categorized by initial resuscitation strategy into four groups: RD-/ECPR-, RD+/ECPR-, RD-/ECPR+, and RD+/ECPR+.

resultsA total of 150 studies were included, comprising predominantly case reports and describing 268 pregnant patients with cardiac arrest and 274 neonates from 34 countries (2000-2025). Initial resuscitation strategies were RD-/ECPR- in 71/268 (26.5%), RD+/ECPR- in 184/268 (68.7%), RD-/ECPR + in 5/268 (1.9%), and RD+/ECPR + in 8/268 (3.0%). Favorable neurological outcomes were reported in 37/61 (61.9%), 39/146 (26.7%), 4/5 (80.0%), and 2/8 (25.0%), respectively, among cases with available data. Maternal survival beyond ICU admission (mid-term survival) was observed in 46/66 (69.7%), 69/171 (40.3%), 5/5 (100%), and 6/8 (75.0%), respectively. Neonatal survival beyond ICU admission was observed in 29/58 (50.0%), 61/101 (60.4%), 3/5 (60.0%), and 4/7 (57.1%). Among cases receiving both RD and ECPR, ECPR was initiated after RD in six cases and preceded RD in one case.

conclusionsMaternal and neonatal outcomes after cardiac arrest during pregnancy varied widely across resuscitation strategies. The available evidence is limited by small, case-based reports, highlighting the need for large registries and multicenter studies to define the optimal use and sequencing of RD and ECPR.

trial registrationA preplanned protocol for systematic review has been registered in the Open Science Framework (Osf.io) [ https://osf.io/9xsrt/files/osfstorage ].

Indexed as

Cardiopulmonary ResuscitationExtracorporeal Membrane OxygenationHeart ArrestPregnancy Complications, CardiovascularAdultFemaleHumansInfant, NewbornMaternal MortalityPregnancyRisk FactorsTime FactorsTreatment OutcomeCPRExtracorporeal cardiopulmonary resuscitationPerimortem cesarean sectionResuscitative hysterotomyVenoarterial extracorporeal membrane oxygenation

Identifiers

PMID42271244
PMCPMC13474558

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.