[Perimortem caesarean section during maternal arrest]

Area of Science:

• Emergency Medicine
• Obstetrics & Gynecology
• Critical Care Medicine

Background:

• Maternal cardiac arrest is a rare but critical event in county hospitals.
• Prompt intervention is crucial for both maternal and fetal survival.
• Established local emergency guidelines and protocols are essential for managing such emergencies.

Purpose of the Study:

• To highlight the critical timing and indications for perimortem cesarean section.
• To present a case demonstrating the successful application of perimortem cesarean section.
• To emphasize the importance of teamwork and communication in achieving favorable outcomes.

Main Methods:

• A perimortem cesarean section performed within 4 minutes of maternal cardiac arrest.
• Procedure indicated from 20 weeks gestation or when "visibly pregnant".
• Performed at the location of maternal cardiac arrest.

Main Results:

• Perimortem cesarean section may increase the chances of maternal return of spontaneous circulation (ROSC).
• Physiological benefits include increased venous return, enhanced lung expansion, and reduced uterine blood flow.
• Case report details a successful perimortem cesarean section with full recovery for both mother and child.

Conclusions:

• Perimortem cesarean section is a time-sensitive procedure with potential to improve maternal and fetal outcomes.
• Effective teamwork and clear communication are vital for successful management of maternal cardiac arrest.
• Well-defined local protocols are crucial for county hospitals managing rare but critical obstetric emergencies.