Management of Perimortem Cesarean Delivery in Pregnant Patients with Cardiac Arrest: A Best Evidence Summary

Background This review aims to provide medical professionals with a scientific summary of evidence regarding the management of emergency cesarean sections during pregnancy. The research question is "How to provide professional cesarean section management for pregnant patients in critical condition?" Methods Relevant evidence regarding the management of perimortem cesarean delivery in pregnant patients with cardiac arrest was systematically retrieved from computerized decision support systems, guideline databases, professional association websites, and Chinese and English electronic databases. The evidence types included clinical decision-making tools, clinical practice guidelines, expert consensus statements, evidence summaries, systematic reviews, and randomized controlled trials, with the retrieval time frame ranging from database inception to August 2025. Three researchers independently assessed the quality of the included literature, followed by the extraction, collation, and synthesis of evidence from eligible studies. Results A total of 17 articles were included, including 8 expert consensuses, 8 guidelines, and 1 cohort study. 27 pieces of evidence were extracted from 6 aspects: early risk warning, indicators and timing, surgical procedures, fetal management, post-resuscitation management, and team training. Conclusion This study summarizes the best evidence for the management of pregnant patients with cardiac arrest during labor during the perioperative period, providing an evidence-based basis for healthcare professionals to conduct emergency cesarean delivery for pregnant patients with cardiac arrest. When translating into clinical practice, it is necessary to consider the clinical context and the actual situation of the patients comprehensively, and select the best evidence in a personalized manner to reduce the maternal and fetal mortality rates, improve the prognosis and quality of life. Trial registration: The study has been registered with the Evidence-Based Nursing Centre at Fudan University (ES20258777).