Targeted temperature management following third trimester cardiac arrest

Background: According to the American Heart Association (AHA), post-cardiac arrest use of targeted temperature management (TTM) can be considered for pregnant patients; however, data is lacking, particularly following fetal viability. Case: A 31 year old, female presented at 36 weeks gestation after an out-of-hospital cardiac arrest. Resuscitation resulted in return of spontaneous circulation (ROSC); however, the patient was unresponsive upon hospital arrival. She underwent TTM, was cooled and rewarmed without incident. She underwent cesarean delivery 36 hours after cardiac arrest. By time of discharge, she had full neurological recovery, with only amnesia surrounding the acute cardiac event. The neonate was discharged after a brief stay in the neonatal intensive care unit, having met discharge criteria. Conclusion: TTM should be considered post cardiac arrest, even in the third trimester. Keywords: Targeted temperature management; Cardiac arrest; Pregnancy. Abbreviations: AHA: American Heart Association; TTM: Targeted Temperature Management; ROSC: Return Of Spontaneous Circulation; EMS: Emergency Medical Services; ARCTIC: Advanced Resuscitation Cooling Therapeutics Intensive Care; NICU: Neonatal Intensive Care Unit; OHCA: Out of Hospital Cardiac Arrest.