Purpose of the study 
Guidelines for CPR in pregnancy deviate from regular CPR. Incident of cardiac arrest in pregnant women is estimated to one of 30 000 pregnancies. Maternal mortality rate in Norway in 2015 was 5 in 100.000 pregnancies. Hence, one might expect 2-5 cardiac arrests every year pregnant women in Norway (World Health Organization, 2015). The purpose of this study was to measure self-reported level of competence about maternal cardiac arrest. 

Materials and methods
To measure level of competence, a self-report instrument was developed and validated during spring 2019. The instrument; Competence in Cardiac arrest in pregnancy (ComCA-P), covered five thematic areas: demographic information, training, knowledge and competence, role and functions and knowledge about perimortem cesarean section (PMCS). 

Results
ComCA-P was distributed in six different wards with 527 health care providers. The total response rate was 47% (n=250), of whom 125 had further education. Extensive need for more knowledge (1) and training/simulation (2) was reported by 78% and 84% of the responders, respectively.The self-assessment on competence showed that 71.8 % were informed/well informed about warning routines. The area with very low self-assessment was knowledge about medications and circulation. The thematic area about role showed that 67 % was unsure or did not know their role during maternal cardiac arrest. Knowledge about PMCS, similarly showed an overall low level of knowledge about preparations, equipment and birth/delivery. 

Conclusions
Since cardiac arrest is rare in pregnant women, it is challenging to maintain a high level of competence. However, it is crucial that health care providers have basic knowledge. The results showed that the overall self-assessed competence was generally low, and the need for more training was necessary.

5 - Health care providers self-assessed competence about cardiac arrest in pregnancy