The etiology of maternal cardiopulmonary arrest is highly associated with outcomes of perimortem cesarean section

Perimortem Cesarean Section in a Patient with Intrapartum Cardiorespiratory Arrest Due to a Massive Amniotic Fluid Embolism

“…Because neonatal survival is described even in a case where delivery occurred 20 minutes after maternal arrest, urgent PMCS is also beneficial for newborns. Moreover, the reduction of the gravid uterus improves reanimation procedures with the enhancement of cardi- ac output, the decrease of aorto-caval compression, and the possibility of better ventilation and transdiaphragmatic heart massage if necessary [5,7,8].…”

“…The outcome depends on urgent coordinated action of gynecologists, anesthesiologists, and neonatologists and the development of possible complications such as obstetric shock, multiple organ dysfunction syndrome (MODS), and disseminated intravascular coagulation (DIC). In such cases, a perimortem cesarean section (PMCS) should be performed with a goal of better resuscitation of the mother and improvement of fetal survivability 1 2 3 4 5 . This procedure is mandatory due to the professional, ethical, and medico-legal aspects.…”

Letter to “Aortic dissection during pregnancy and puerperium: A Japanese nationwide survey”

“…Finally, due to the publication bias, the cases with favorable outcomes are easy to accept; however, the cases with unfavorable outcomes are concealed or hard to accept. 3 We consider that the incidence of aortic dissection in pregnancy is a little higher and the maternal survival rate may be lower in reality, including the sudden deaths out of hospital without autopsy. We also want to emphasize that the pregnant woman with high-risk factors of aortic dissection should be transferred to the hospital where surgical repair of aortic dissection is available due to the high mortality.…”