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Cesarean delivery of twins during maternal cardiopulmonary arrest
1Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, USA.
Background:
In modern times, maternal death is rare. Timely cesarean delivery in the setting of maternal cardiopulmonary arrest may save both the infant and the mother.
Case:
A 36-year-old white woman with a twin pregnancy suffered cardiopulmonary arrest at 28 weeks' gestation. Advanced cardiopulmonary resuscitative measures were unsuccessful, and the twins were delivered by cesarean at the bedside. Immediately after delivery, a maternal pulse was noted; both the mother and her infants are alive 15 months later.
Conclusion:
Relieving vena caval occlusion by perimortem cesarean delivery in a term gravida allows chest compressions to provide sufficient cardiac output in the unfortunate event of maternal cardiopulmonary arrest. When delivery occurs within 5 minutes of maternal insult, the neonatal outcome is favorable.