Frequency and Management of Maternal Peripartum Cardiac Arrest during Anesthetic Care: A Multicenter Retrospective Cohort Analysis
Authors' conclusion
During peripartum anesthetic management in the United States, maternal cardiac arrests most commonly arise from hemorrhage and amniotic fluid embolism.
Study context
- Population
- Patients aged 15 to 44 yr receiving anesthetic care for delivery and up to 7 days postpartum, Multicenter Perioperative Outcomes Group database, US, 2015–2022deliveries, 60 institutions
- Participants
- 778,102 patients
- Outcome
- Frequency of peripartum, perianesthetic maternal cardiac arrest
Methodological detailsmulticentre, observational, manual chart review by two independent reviewers
- Multicentre
- Observational
- Manual chart review by two independent reviewers
Main finding
As reported in the abstract
Maternal cardiac arrest during peripartum, perianesthetic care
Cardiac arrests identified
87
Frequency per 100,000 deliveries
11.2
95% CI 9.1 to 13.8
Observational data: associations, not effects.
Further findings
Etiology of arrest
- Hemorrhage
- 40.2%
- Amniotic fluid embolism
- 31.0%
- Anesthetic complications (e.g., high neuraxial block)
- 11.5%
Arrests during cesarean deliveries
- Proportion of arrests during cesarean deliveries
- 67.8%
Outcomes after arrest
- ROSC achieved
- 77.0%
- Survival to 30 days
- 67.8%
- Median postanesthetic hospital LOS (days)
- 6
Factors associated with arrest
- Demographic: age 40 yr or older, BMI 40 kg/m 2 or higher, Black race, Asian or Pacific Islander race
- Clinical (strongest): pulmonary hypertension, placenta accreta spectrum, ischemic heart disease, stillbirth
Potential deviations from societal cardiac arrest guidelines
- Arrests with potential guideline deviations
- 18.4%
Original publication
Frequency and Management of Maternal Peripartum Cardiac Arrest during Anesthetic Care: A Multicenter Retrospective Cohort Analysis. Anesthesiology. Published 23 December 2025. doi:10.
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