Perimortem caesarean section – why, when and how

Research output: Contribution to journalArticlepeer-review

Authors

  • Kim Hinshaw
  • Sara Paterson-Brown
  • Tracey Johnston
  • Margaret Matthews
  • Julian Webb
  • Paul Sharpe

Colleges, School and Institutes

External organisations

  • City Hospitals Sunderland NHS Foundation Trust, Sunderland, SR4 7TP
  • Queen Charlotte's Hospital Imperial NHS Trust, London, W12 0HS
  • Tunbridge Wells Hospital, Tunbridge Wells, Kent, TN2 4QJ
  • Surrey and Sussex Healthcare NHS Trust, East Surrey Hospital, Redhill, RH1 5RH
  • Leicester Royal Infirm
  • Birmingham Women's NHS Foundation Trust

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.

Details

Original languageEnglish
Pages (from-to)151-158
JournalThe Obstetrician and Gynaecologist
Volume20
Issue number3
Early online date21 Jun 2018
Publication statusPublished - Jul 2018