Key result
Perimortem cesarean delivery during maternal arrest restores pulse and yields 15-month maternal and twin survival.
Why the study?
Does perimortem cesarean delivery improve survival in a pregnant woman with cardiopulmonary arrest?
Case Report (n=1)
No
Does perimortem cesarean delivery improve survival in a pregnant woman with cardiopulmonary arrest?
Perimortem cesarean delivery can relieve vena caval occlusion and restore maternal cardiac output during cardiopulmonary arrest, potentially saving both mother and infants.
May support perimortem cesarean in maternal arrest; leaves open generalizability without higher-level evidence.
BACKGROUND: In modern times, maternal death is rare. Timely cesarean delivery in the setting of maternal cardiopulmonary arrest may save both the infant and the mother. CASE: A 36-year-old white woman with a twin pregnancy suffered cardiopulmonary arrest at 28 weeks' gestation. Advanced cardiopulmonary resuscitative measures were unsuccessful, and the twins were delivered by cesarean at the bedside. Immediately after delivery, a maternal pulse was noted; both the mother and her infants are alive 15 months later. CONCLUSION: Relieving vena caval occlusion by perimortem cesarean delivery in a term gravida allows chest compressions to provide sufficient cardiac output in the unfortunate event of maternal cardiopulmonary arrest. When delivery occurs within 5 minutes of maternal insult, the neonatal outcome is favorable.
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Richard J. Cardosi (1998) conducted a case report in Maternal cardiopulmonary arrest (n=1). Perimortem cesarean delivery was evaluated on Maternal and fetal survival. Perimortem cesarean delivery during maternal cardiopulmonary arrest at 28 weeks' gestation resulted in the return of maternal pulse and survival of both the mother and twins at 15 months.
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