Perimortem cesarean delivery 30 minutes after a laboring patient jumped from a fourth-floor window: Baby survives and is normal at age 4 years

Capobianco, Giampiero; Balata, Antonio; Mannazzu, Maria Chiara; Oggiano, Riccardo; Nossai, Loreta Pinna; Cherchi, P; Dessole, Salvatore

doi:10.1016/j.ajog.2007.09.007

Cited by 30 publications

(10 citation statements)

References 4 publications

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“…Four of 17 infants were delivered without sequelae, despite the fact that PMCS was performed more than 15 min after maternal cardiopulmonary arrest [4]. Some other case reports showed that clinically normal children were delivered by PMCS 15 min after the onset of maternal arrest [2,6,7]; however, these reports pointed out the necessity of rapid PMCS. From the fetal viewpoint, tolerance for hypoxia might contribute to intact survival in our case.…”

Section: Discussionmentioning

confidence: 66%

What enabled mother and twins to survive 18 minutes after maternal cardiopulmonary arrest?

Matsuoka

Tanaka

Dohi

et al. 2014

Case Reports in Perinatal Medicine

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A woman carrying monochorionic twins underwent sudden cardiopulmonary arrest at 31 weeks of gestation due to spontaneous coronary artery dissection in the hospital. The resuscitation techniques, with her uterus manually displaced to her left, were initiated immediately and maternal spontaneous circulation was resumed 18 min later. A cesarean section was performed 2 h after the revival and the patient was kept hypothermic for 24 h. Finally, full recovery of both mother and twins was achieved. As in this case, the resuscitation techniques for pregnant women recommended by the American Heart Association, and therapeutic hypothermia, might be effective and contribute much to the survival and recovery of patients.

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Section: Discussionmentioning

confidence: 66%

What enabled mother and twins to survive 18 minutes after maternal cardiopulmonary arrest?

Matsuoka

Tanaka

Dohi

et al. 2014

Case Reports in Perinatal Medicine

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“…Neonatal survival is associated with increasing gestational age [2], but also the time interval from cardiac arrest to delivery seems to be critical [9]. However, in few case reports, exceptionally long time intervals, up to 30–45 min from cardiac arrest to emergency hysterotomy, have been described with normal neurological outcome at the age of 4 years (30 min from CA) and 6 months (45 min from CA) [10, 11]. …”

Section: Discussionmentioning

confidence: 99%

Two cases of low birth weight infant survival by prehospital emergency hysterotomy

Tommila

Pystynen

Soukka

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundDuring maternal cardiac arrest, emergency hysterotomy (EH) is recommended after four minutes of resuscitation, if no signs of spontaneous circulation are detected. This extreme procedure is believed to be potentially beneficial for both the mother and the infant. Both maternal and neonatal survivals seem to be associated to the time delay between the cardiac arrest and the delivery and in-hospital resuscitation location. In addition to this, gestational age is an important determinant to neonatal outcome.Case presentationWe report two emergency hysterotomies executed in an out-of-hospital location. The infants delivered by EH were low birth weight infants and born 20–23 min after maternal cardiac arrest. Both infants survived and had normal physical and neurological growth at the age of two years. Unfortunately, mothers in these both cases died in the field.ConclusionContrary to earlier beliefs, it is possible to perform a successful EH also in out-of-hospital setting, even with incomplete surgical skills. However, training and preparation are extremely important for achieving the highest possible readiness to treat maternal cardiac arrest situations also prehospitally.

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“…The mother had committed suicide by jumping from the fourth floor of the hospital while in labour 22. The perceived time of maternal cardiac arrest (as determined by loss of central pulses and signs of life) may not always be the same as the time that circulation ceases.…”

Section: Discussionmentioning

confidence: 99%

Perimortem caesarean section

2015

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This review describes a simple approach to perimortem caesarean section (PMCS) that can be used by a doctor in the resuscitation room or prehospital environment when faced with a mother of more than 20 weeks gestation in cardiac arrest. It explores the indications for and contraindications to the procedure, the physiological rationale behind it, equipment needed, technical aspects of the procedure and reviews recent literature on maternal and fetal outcomes. Like other uncommon procedures such as emergency department thoracotomy, rehearsal and preparation for a PMCS is essential to give both mother and baby the best chance of survival.

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Perimortem cesarean delivery 30 minutes after a laboring patient jumped from a fourth-floor window: Baby survives and is normal at age 4 years

Cited by 30 publications

References 4 publications

What enabled mother and twins to survive 18 minutes after maternal cardiopulmonary arrest?

What enabled mother and twins to survive 18 minutes after maternal cardiopulmonary arrest?

Two cases of low birth weight infant survival by prehospital emergency hysterotomy

Perimortem caesarean section

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