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Cardiac arrest is relatively an uncommon event during cesarean sections. That’s why obstetric teams have low exposure to these critical situations and need frequent training in early identification, differential diagnosis and treatment. We present a case report of a 36-year-old woman, who underwent cesarean section under spinal anesthesia due to delayed labor progress. Once the skin incision was performed the patient underwent asystole. There is a wide range of etiologies for maternal cardiac arrest. We describe and analyze the possible etiologies that could have led to cardiac arrest in this particular case. Citation: Germanova L, Czajkowska K, Gomes J, Infante C, Castro M, Martins I. Cardiac arrest during cesarean section - A case report. Anaesth pain & intensive care 2019;23(4)__ Received: 10 September 2019, Reviewed: 28 September, 23 October 2019, Revised: 24 October 2019, Accepted: 28 October 2019

Background Informed consent is essential in current medical practice and should be a global standard to be sought at all instances when doctors interact with patients. The aim of this study was to evaluate compliance to the guidelines of the Portuguese health entity regarding the correct filling process of informed consent. Methods A prospective observational survey was conducted upon arrival of the patient at the operating room of a tertiary teaching hospital center in Portugal, in march 2021, to verify the presence of informed consent in the clinical process. A sample of 202 clinical files was randomly collected. Results Only 47% of the patients had the informed consent document in the clinic process and only 45% of the total clinical files had the informed consent signed by the patient. Merely 21.8% of the informed consents respected all the items recommended by the guidelines of the Portugal health entity. Most of the surgical informed consent (SIC) had only basic information and only a lower percentage had reports about the surgical procedure, information regarding the treatment, possible consequences of a missed treatment or complications and possible treatment alternatives. Those results didn’t conform to the standard regulations of the Portuguese health guidelines regarding SIC. Conclusion Even though improvements in SIC were attained in recent years, our study suggests that the implementation of SIC is still suboptimal in surgical practice. It is important to raise awareness for the obtention of SIC by the healthcare team, because complete information before an invasive procedure is an ethical requirement.

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We report a healthy 29-year-old primigravida at 38 weeks gestation who underwent elective cesarean section and suffered from Horner’s syndrome and trigeminal palsy following epidural anaesthesia. The prompt recognition of this complication associated with lumbar epidural anaesthesia requiring close monitoring of the patient in order to prevent autonomic complications has been addressed.