ABSTRACT
Understanding the anatomic and physiologic adaptations during pregnancy is critical to optimizing outcomes when responding to maternal cardiac arrest. This chapter reviews the anatomy and physiology of the various systems in pregnancy compared to the nonpregnant adult and sets the stage for the recommended modifications of CPR in pregnancy. It describes the variations in anatomy and physiology encountered during pregnancy, and discusses maternal vulnerabilities that result from changes in the cardiovascular, respiratory, hematologic, gastrointestinal, genitourinary, endocrinologic, and immunologic systems. Normal pregnancy results in several physiologic changes in the maternal nervous system. These changes can be categorized into central nervous system changes, peripheral/autonomic nervous system changes, and cerebrovascular adaptations. Cerebral autoregulation appears to be enhanced during normal pregnancy but impaired during hypertensive pregnancy and in the postpartum period. Pregnancy also results in an increased risk of thrombosis due to its multiple effects on Virchow’s triad (hypercoagulability, venous stasis, and vascular damage).
