Resuscitative hysterotomy for maternal collapse in a triplet pregnancy

Tambawala, Zenab Yusuf; Cherawala, Masuma; Maqbool, Sadia; Hamza, Lama Khalid

doi:10.1136/bcr-2020-235328

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…When maternal collapse unfortunately happens, resuscitative hysterotomy, often called a perimortem cesarean section, is a procedure that is frequently carried out during the second and third trimesters of pregnancy. Immediate hysterotomy may be necessary if the lady does not react to first cardiopulmonary resuscitation (CPR) and manual uterine displacement [ 4 ]. Anesthesia problems are a substantial cause of maternal cardiac arrest in affluent countries.…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary Arrest During Pregnancy: A Review Article

Pawar¹,

Anjankar²,

Anjankar³

et al. 2023

Cureus

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Massive pulmonary embolism (PE) is an uncommon but severe complication of pregnancy or during the first few weeks after giving birth. Our intention was to thoroughly analyze the information available to its management methods. Significant bleeding of mother survival and early deliveries in fetal survivals were having hemorrhage and were having key outcomes. We found 127 severe PE cases that have had at least one form of treatment (at least 83% big; 23% with cardiac arrest). The 83 women who received thrombolysis had a 94% (95%) survival rate. Cardiac arrest in pregnancy is uncommon, although maintaining current competency can be challenging. While maternal mortality rates have decreased globally over the past 25 years, they have increased in the United States. The intricacy of the maternal mortality issue is a result of a number of clinical and socioeconomic problems such as unequal healthcare access, racial and ethnic disparities, maternal comorbidities, and bias in epidemiologic ascertainment. The importance of doctors being prepared to react to a potential maternal cardiac arrest in any situation where they are providing treatment for pregnant women is highlighted by the rise in maternal mortality. For the treatment of maternal cardiac arrest, an interdisciplinary team with expertise in both the maternal resuscitation procedure and the physiological changes that take place during pregnancy is necessary. Additionally offered are basic and advanced cardiac life support protocols. Techniques to remove obstacles like aortocaval compression that could impair the effectiveness of resuscitation should be used.

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Section: Introductionmentioning

confidence: 99%

Cardiopulmonary Arrest During Pregnancy: A Review Article

Pawar¹,

Anjankar²,

Anjankar³

et al. 2023

Cureus

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“…The presence of a gravid uterus after 20 weeks of pregnancy makes maternal resuscitation difficult. The chest compressions delivered during the procedure of cardiopulmonary resuscitation are less effective due to presence of gravid uterus 4 . American Heart Association suggests that perimortem caesarean section (PMCS) is the most effective way to resuscitate pregnant women in cardiac arrest.…”

Section: Introductionmentioning

confidence: 99%

“…It is not necessary to shift the woman to the operating room the procedure can be performed in the emergency room (ER) by the attending professional. The procedure is termed as resuscitation hysterotomy, if it is done by the ER personnel 4 . Immediate decision of performing the procedure may help in decreasing the maternal mortality as well, by improving upon the chances of maternal resuscitation 10 .…”

Section: Introductionmentioning

confidence: 99%

Maternal and Perinatal Outcome of Perimortem Caesarean Section

Khan¹,

Jamil²,

Butt³

et al. 2023

PJMHS

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Aim: To describe characteristics, etiological factors, maternal and perinatal outcome of perimortem Caesarean section. Design: Prospective study Setting: Emergency Room of Department of Obstetrics & Gynecology Unit IDr.Ruth KM Pfau Civil Hospital & Dow Medical College, Karachi. Methodology: This study was carried out in the Department of Obstetrics and Gynaecology, Civil Hospital Karachi from November 2020 to March 2021. All women who were presented in emergency in a collapsed state were included in the study and those women who were brought dead were excluded. Clinical details including age, gestational age, reason for perimortem Caesarean section, perinatal and maternal outcome were recorded on a predesigned proforma. Results: A total of 27 women underwent perimortem Cesarean section. The mean age of women who underwent PMCS was 266.5 years, and mean gestational age was 35±4weeks. Sixteen (59%) women were referred from either primary care or small clinics. Majority 15(55%), underwent PMCS within 5 minutes of maternal collapse and 12(44%) underwent PMCS, after 5 minutes of collapse. Septic shock 21(77%) was the main etiological factor for PMCS, followed by hypertension and cardiomyopathy 2(7%) each. Twenty three (85%) women survived, following PMCS, whereas 4(14%) died. Reasons for maternal death included hepatic encephalopathy(1), peripartum cardiomyopathy(2), eclampsia(1). The perinatal mortality was high, with only 14(51%) live birth and mean APGAR score at 1 and 5 minutes was 3. The mean stay in intensive care was 37 35 hours, whereas mean stay in ward was 5739 hours. Practical implications: This study suggests that if perimortem caesarean section accomplished in a timely manner, it can improve fetomaternal outcome. Conclusion: Perimortem Caesarean section can improve upon maternal survival. Greater awareness among doctors, multidisciplinary approach, proper documentation and information for family members are cornerstone of this emergency procedure. Keywords: Perimortem Cesarean section, septic shock,eclampsia,postpartumhaemorrhage, maternal mortality.

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“…Obstetric emergencies, such as hemorrhagic and hypertensive disorders, amniotic fluid embolism and anesthetic complications contribute to the involvement of pregnant women by CPA (3) . In cases of multiple pregnancies, associated with comorbidities, the risks tend to be higher, due to the physiological changes of pregnancy that imply a change in maternal cardiovascular overload (4) .…”

Section: Introductionmentioning

confidence: 99%

Obstetric cardiopulmonary arrest: construction and validation of an instrument to assess nursing knowledge

Silva

Grimaldi

et al. 2022

Rev. Gaúcha Enferm.

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Objective To build and validate an instrument to assess nursing knowledge about obstetric cardiopulmonary arrest. Methods A methodological study consisting of the construction of the instrument, content validation by 23 experts and validation of internal consistency with 74 nursing professionals and 99 nursing students. Items with a minimum agreement of 90%, verified from the Content Validation Index, Content Validity Ratio and binomial test were considered valid. Cronbach’s alpha was used to verify internal consistencyand a value greater than 0.6 was classified as acceptable. Results The instrument consisted of 16 multiple-choice questions, from the 16 items evaluated, eight had 100% agreement by the experts and six had 95%. The lowest content validity ratio was 0.82 and Cronbach’s alpha was 0.694. Conclusions The instrument was constructed and validated, and its use is recommended to assess knowledge in obstetric cardiopulmonary arrest.

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Resuscitative hysterotomy for maternal collapse in a triplet pregnancy

Cited by 5 publications

References 8 publications

Cardiopulmonary Arrest During Pregnancy: A Review Article

Cardiopulmonary Arrest During Pregnancy: A Review Article

Maternal and Perinatal Outcome of Perimortem Caesarean Section

Obstetric cardiopulmonary arrest: construction and validation of an instrument to assess nursing knowledge

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