Perimortem caesarean section – why, when and how

Justin Chu; Kim Hinshaw; Sara Paterson-Brown; Tracey Johnston; Margaret Matthews; Julian Webb; Paul  Sharpe

doi:10.1111/tog.12493

Perimortem caesarean section – why, when and how

Justin Chu, Kim Hinshaw, Sara Paterson-Brown, Tracey Johnston, Margaret Matthews, Julian Webb, Paul Sharpe

Metabolism and Systems Science

Research output: Contribution to journal › Review article › peer-review

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Abstract

Key content
• Cardiac arrest in pregnancy is rare. Effective management involves the decision to perform a perimortem caesarean section if the gestation is greater than 20 weeks and return of spontaneous circulation does not occur after 4 minutes of effective cardiopulmonary resuscitation.
• Delivery should ideally be achieved within 5 minutes of cardiac arrest as this maximises maternal survival and reduces the risk of long‐term neurological impairment.
• In hospital, the procedure should be undertaken at the site of the cardiac arrest without moving to an operating theatre.
• Minimal equipment is required to undertake the procedure. Clinical areas where pregnant women are seen should have a designated ‘equipment box’.
• Debriefing all personnel is of utmost importance after the acute event.

Learning objectives
• To understand why perimortem caesarean section is beneficial to maternal survival.
• To appreciate the need for rapid decision making when perimortem caesarean section is required.
• To gain practical knowledge of perimortem caesarean section, including the steps to be used when resuscitation is unsuccessful.

Ethical issues
• To be aware that the primary aim of perimortem caesarean section is to aid maternal survival, not necessarily fetal survival.

Original language	English
Pages (from-to)	151-158
Number of pages	8
Journal	The Obstetrician and Gynaecologist
Volume	20
Issue number	3
Early online date	21 Jun 2018
DOIs	https://doi.org/10.1111/tog.12493
Publication status	Published - Jul 2018

Keywords

cardiac arrest
maternal cardiac arrest
perimortem caesarean section
resuscitative hysterotomy

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10.1111/tog.12493

Chu_et_al_Perimorten_Caesarean_The_Obstetrician_and_Gynaecologist_2017
Checked for eligibility: 10/11/2017 "This is the peer reviewed version of the following article: Chu JJ, Hinshaw K, Paterson‐Brown S, Johnston T, Matthews M, Webb J, Sharpe P. Perimortem caesarean section – why, when and how. The Obstetrician & Gynaecologist. 2018; 20:151–158, which has been published in final form at: https://doi.org/10.1111/tog.12493. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."
Accepted author manuscript, 352 KBLicence: None: All rights reserved

Cite this

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abstract = "Key content• Cardiac arrest in pregnancy is rare. Effective management involves the decision to perform a perimortem caesarean section if the gestation is greater than 20 weeks and return of spontaneous circulation does not occur after 4 minutes of effective cardiopulmonary resuscitation.• Delivery should ideally be achieved within 5 minutes of cardiac arrest as this maximises maternal survival and reduces the risk of long‐term neurological impairment.• In hospital, the procedure should be undertaken at the site of the cardiac arrest without moving to an operating theatre.• Minimal equipment is required to undertake the procedure. Clinical areas where pregnant women are seen should have a designated {\textquoteleft}equipment box{\textquoteright}.• Debriefing all personnel is of utmost importance after the acute event.Learning objectives• To understand why perimortem caesarean section is beneficial to maternal survival.• To appreciate the need for rapid decision making when perimortem caesarean section is required.• To gain practical knowledge of perimortem caesarean section, including the steps to be used when resuscitation is unsuccessful.Ethical issues• To be aware that the primary aim of perimortem caesarean section is to aid maternal survival, not necessarily fetal survival.",

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AU - Webb, Julian

AU - Sharpe, Paul

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N2 - Key content• Cardiac arrest in pregnancy is rare. Effective management involves the decision to perform a perimortem caesarean section if the gestation is greater than 20 weeks and return of spontaneous circulation does not occur after 4 minutes of effective cardiopulmonary resuscitation.• Delivery should ideally be achieved within 5 minutes of cardiac arrest as this maximises maternal survival and reduces the risk of long‐term neurological impairment.• In hospital, the procedure should be undertaken at the site of the cardiac arrest without moving to an operating theatre.• Minimal equipment is required to undertake the procedure. Clinical areas where pregnant women are seen should have a designated ‘equipment box’.• Debriefing all personnel is of utmost importance after the acute event.Learning objectives• To understand why perimortem caesarean section is beneficial to maternal survival.• To appreciate the need for rapid decision making when perimortem caesarean section is required.• To gain practical knowledge of perimortem caesarean section, including the steps to be used when resuscitation is unsuccessful.Ethical issues• To be aware that the primary aim of perimortem caesarean section is to aid maternal survival, not necessarily fetal survival.

AB - Key content• Cardiac arrest in pregnancy is rare. Effective management involves the decision to perform a perimortem caesarean section if the gestation is greater than 20 weeks and return of spontaneous circulation does not occur after 4 minutes of effective cardiopulmonary resuscitation.• Delivery should ideally be achieved within 5 minutes of cardiac arrest as this maximises maternal survival and reduces the risk of long‐term neurological impairment.• In hospital, the procedure should be undertaken at the site of the cardiac arrest without moving to an operating theatre.• Minimal equipment is required to undertake the procedure. Clinical areas where pregnant women are seen should have a designated ‘equipment box’.• Debriefing all personnel is of utmost importance after the acute event.Learning objectives• To understand why perimortem caesarean section is beneficial to maternal survival.• To appreciate the need for rapid decision making when perimortem caesarean section is required.• To gain practical knowledge of perimortem caesarean section, including the steps to be used when resuscitation is unsuccessful.Ethical issues• To be aware that the primary aim of perimortem caesarean section is to aid maternal survival, not necessarily fetal survival.

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Perimortem caesarean section – why, when and how

Abstract

Keywords

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