Maternal Arrest; Roadside to Resus

Maternal cardiac arrest requires immediate, specialized interventions due to unique physiological changes, including reduced functional residual capacity and aortocaval compression from the gravid uterus. Standard advanced life support remains the foundation, but manual uterine displacement is critical to improve cardiac output after 20 weeks of gestation. Resuscitative hysterotomy serves as a life-saving procedure for the mother, with potential survival benefits for the fetus if performed within five minutes of arrest. Evidence from recent systematic reviews, presented by emergency medicine expert Caroline Leech, indicates that while maternal survival rates remain low, neonatal outcomes are surprisingly favorable, even in cases of prolonged maternal downtime. Effective management demands early pre-alerting, multi-disciplinary team coordination, and a clear, pragmatic approach to both maternal and neonatal resuscitation, emphasizing that high-quality basic life support is the primary driver of successful outcomes.