Successful outcome utilizing hypothermia after cardiac arrest in pregnancy: a case report

To date, pregnancy has been considered a contraindication to the use of therapeutic hypothermia after cardiac arrest.

We present the case of a 35-yr-old woman, 13 wks pregnant, who had a witnessed out-of-hospital ventricular fibrillation cardiac arrest. She was resuscitated by prehospital personnel yet remained comatose at arrival to the hospital. Therapeutic cooling (33 degrees C) was initiated for 24 hrs, and she was discharged home with mild neurologic deficit (Cerebral Performance Category 2) on hospital day 6. The infant was delivered via cesarean section at 39 wks' gestation. Apgar scores were 8 and 9, and neurodevelopmental testing was appropriate for age at birth and at 2 months.

This is the first case of therapeutic hypothermia applied to postarrest care of a pregnant woman followed by a successful delivery. This therapy should be considered in pregnant patients with cardiac arrest.