Field perimortem cesarean section

Bowers, Wilson; Wagner, Christopher

doi:10.1016/s1067-991x(01)70047-8

Cited by 15 publications

(3 citation statements)

References 3 publications

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“…This finding is in accordance with the very limited survival reported by others from prehospital maternal cardiac arrest. 12 In theory, when applied in the right manner and time, one would expect the PMCS to give a lower case fatality rate than resuscitation alone. We cannot confirm this theory with our data.…”

Section: Discussionmentioning

confidence: 99%

Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training?

Dijkman

Huisman

Smit

et al. 2010

BJOG

183

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Please cite this paper as: Dijkman A, Huisman C, Smit M, Schutte J, Zwart J, van Roosmalen J, Oepkes D. Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training? BJOG 2010;117:282–287. Objective Management of cardiac arrest in pregnancy is recommended to include perimortem caesarean section (PMCS) in the Managing Obstetric Emergencies and Trauma (MOET) course. In this study, we aimed to assess maternal and neonatal outcome of all cases of PMCS in the Netherlands performed in the last 15 years, and to test the hypothesis that PMCS was used more often since the introduction of the MOET‐course in 2004. Design Retrospective cohort study. Setting Nationwide assessment of all cases of PMCS inside or outside hospitals. Population All known cases of PMCS in the Netherlands from 1993 to 2008. Methods Data collection through contacting all Dutch obstetricians and all MOET and Advanced Trauma Life Support instructors. All cases of cardiac arrest during pregnancy were collected by cross‐checking with data from the Dutch Maternal Mortality Committee and a nationwide severe maternal morbidity study. Main outcome measures Incidence and case fatality rate of PMCS. Incidence of PMCS before and after introduction of the MOET course. Maternal and neonatal outcome and the process of the PMCS were analysed. Results During the study period, 55 women had a cardiac arrest, 12 of whom underwent a PMCS. Before the introduction of the MOET course, four PMCSs were performed (0.36/year), compared with eight cases after its introduction (1.6/year, P = 0.01). No PMCS was performed within the recommended 5 minutes after starting resuscitation. Eight of the twelve women (67%) regained cardiac output after PMCS, with two maternal and five neonatal survivors. Maternal case fatality rate was 83%. Neonatal case fatality rate was 58%. Conclusions Since the introduction of the MOET course, the use of PMCS has increased. Outcome, however, was still poor. An important factor to improve outcome is more timely application of this potentially life‐saving procedure.

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Section: Discussionmentioning

confidence: 99%

Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training?

Dijkman

Huisman

Smit

et al. 2010

BJOG

183

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“…Prehospital PMCS has very limited survival rates, as reported by others, and is so seldom performed worldwide that it cannot be regarded as a standard of care. 7 If there is indication for prehospital PMCS to be done, we think there should be an experienced prehospital physician to do the procedure.…”

Section: Prehospital Carementioning

confidence: 99%

Cardiac Arrest in Pregnancy: End-Tidal CO2 Monitoring Could Guide Management in the Prehospital Setting

et al. 2016

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This case report describes a 27-year-old pregnant woman with a gestational age of 26 weeks and 3 days who developed cardiac arrest in her home. Resuscitation was started immediately and continued on arrival at the hospital. Guidelines for resuscitation of cardiac arrest during pregnancy in-hospital include that a perimortem caesarean section (PMCS) should be performed if there is no return of spontaneous circulation within 4 minutes. The guidelines for prehospital treatment in such circumstances are more controversial. The triage on-site was based on the end-tidal carbon dioxide (ETCO2) monitoring showing that the quality of resuscitation being done was proficient and after a short on-scene time the patient was transported to the emergency department for PMCS on arrival. The resuscitation of the mother was not successful but the baby survived with no known sequelae after a total arrest time of 28 minutes before delivery. Monitoring of ETCO2 in resuscitation of cardiac arrest in pregnancy might be helpful in making the decision on whether to perform PMCS on-site or at a somewhat more appropriate location in the hospital.

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“…by helicopter) within 4-5 minutes of maternal arrest strong consideration should be made to delaying PMCS until arrival at an environment with obstetric and neonatal support available. In the have been performed(15) although not routinely recommended.…”

mentioning

confidence: 99%

Born to survive: A critical review of out-of-hospital maternal cardiac arrests and pre-hospital perimortem caesarean section

2019

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Title Born to Survive: A critical review of out-of-hospital maternal cardiac arrests and pre-hospital perimortem caesarean section.

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Field perimortem cesarean section

Cited by 15 publications

References 3 publications

Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training?

Cardiac arrest in pregnancy: increasing use of perimortem caesarean section due to emergency skills training?

Cardiac Arrest in Pregnancy: End-Tidal CO2 Monitoring Could Guide Management in the Prehospital Setting

Born to survive: A critical review of out-of-hospital maternal cardiac arrests and pre-hospital perimortem caesarean section

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