Speakers - 2026

Title: Features of the organization of emergency care for pregnant women with critical obstetric conditions

Abstract

Management and assistance to pregnant women in critical obstetric situations in a hospital setting requires impeccable and high-quality CPR and depends not only on the main stages of resuscitation, but also on the organization of the possibility of providing this assistance and interclinical interaction. In particular, in obstetric practice, sudden cardiac arrest associated with pregnancy is extremely rare, and special attention is paid to the organization of emergency care, and the lack of CPR skills can lead to serious consequences. In this case, the primary role in all hospitals was played by the organization of routine interactive simulation medical training (CPR training) with assessment and feedback, as well as the equipment of the hospital and the readiness of all medical personnel to act in critical situations.

The study was conducted over 10 years on the basis of the main perinatal center of Russia, the experience of visiting and auditing various perinatal centers in different regions of Russia was also analyzed.

Over the period 2012-2025, more than 1,000 trainings and workshops were organized in our center and other regions of Russia, including for doctors from other countries (G8). Audits of perinatal centers in various regions of Russia were also conducted, where the level of emergency and urgent care for pregnant women was assessed. Audits of perinatal centers in almost all regions of Russia were conducted. More than 1,000 medical specialists took part in our study: anesthesiologists, obstetricians, nurses, non-doctor staff. Participants completed an 8-hour one-day interactive simulation course, which included the theoretical and practical basics of sudden cardiac arrest in pregnant women and the ALS algorithm we used (ERC 2021 guidelines). We simulate a sudden cardiac arrest scenario in an obstetric department. We asked participants to demonstrate independent ALS skills on a pregnant woman mannequin. After that, the participants independently and with the instructor found and analyzed the main errors. After the analysis and theoretical work, the participants played out the same scenario, and we assessed their knowledge. Before and after the training, we recorded the skills of each participant in our checklist. We asked them how they rated their skills: whether they performed CPR most fully.

An audit of various perinatal centers in Russia was conducted to assess the equipment, readiness and ability to provide emergency care to pregnant women.

During the trainings, we used our checklist to identify the main errors: late call for help / no call for help, slow start of CPR, incorrect chest compressions, long pauses, incorrect or no manual tilt to the left, readiness for emergency cesarean section, poor organization of interaction: insufficient communication skills, poor organization of teamwork. During the audit, we assessed the equipment, the ability to provide emergency communication to all medical personnel, readiness for team interaction, according to the checklist we developed.

This study showed that the ALS knowledge of a group of obstetric specialists before CPR training was insufficient. Interactive simulation-based medical training (3 training stages) appears to be highly effective and demonstrated a positive impact on ALS knowledge of all staff. Well-equipped and team-oriented training, effective teamwork and good communication may play a key role.

What will the audience take away from presentation?

• The current system for organizing emergency care for pregnant women will be presented. Key elements of analysis, assessment, and reporting of pregnant women in critical situations will be presented. Approaches to organizing education and training for providing care will be demonstrated. Mechanisms used to prevent and reduce maternal mortality rates based on the experience of the National Center will be presented. This information can be used in the practice of physicians and healthcare providers to improve the effectiveness of emergency care in critical obstetric conditions.
• The data provided can help solve practical health issues related to improving the quality of diagnosis, treatment and prevention of adverse obstetric events and reducing infant and maternal mortality rates.