Perimortem cesarean section: case reports and recommendations

Perimortem cesarean section is rarely required in the ED. However, since trauma now represents a leading cause of nonobstetric maternal death, emergency physicians (EPs) may more commonly be faced with the difficult decision of performing an emergency cesarean section. Two cases are described of severely traumatized pregnant patients for whom perimortem cesarean section in the ED led to birth of viable infants, with one long-term survivor. The rationale and guidelines for the procedure are discussed, and it is emphasized that the EP should be thoroughly familiar with the procedure and prepared to perform it when indicated to enhance fetal (and potentially maternal) survival.