**6.2 Cardiac arrest**

The early phase of AFE often consists of right ventricular failure which can be identified with the use of transthoracic or transesophageal echocardiography [9, 13]. Findings of echocardiography may include a dilated right ventricle and a collapsed left ventricle with leftward deviation of the interventricular septum [9, 13]. Cardiopulmonary resuscitation (CPR) should be initiated immediately with priority given to high-quality chest compressions before rescue breaths [6]. Standard basic life support (BLS) and advanced cardiac life support (ACLS) protocols should also be initiated [1, 6]. If the fetus is undelivered and has reached a gestational age of potential viability (≥23 weeks), immediate delivery is indicated [1, 2, 6]. Preparation for a perimortem cesarean section should occur simultaneously with the initiation of CPR [1, 10]. The undelivered patient should be placed in a left lateral tilt that displaces the uterus to avoid compression of the aorta and IVC [2, 6]. Patients that progress to cardiac arrest have a dismal prognosis compared to their counterparts with AFE that do not develop cardiac arrest.
