Perimortem Cesarean Section : As Resucitative Hysterotomy On Maternal Cardiac Arrest

Maternal cardiac arrest or maternal collaps is defined as an acute event involving the cardiorespiratory systems and/or brain, resulting in a reduced or absent consciousness level (and potentially death), at any stage in pregnancy and up to six weeks after delivery. Perimortem Cesarean Section (PCS) is performed either during maternal cardiac arrest or during impending maternal cardiac arrest toresuscitate mother and fetal. Current recommendations for maternal resuscitation include performance of the procedure following five minutes of unsuccessful cardiopulmonary resuscitation. The most common aetiology of maternal collaps was know as “4 H and 4 T” (Hypovolemia, Hypoxia, Hypo/Hyperkalemia,Hypothermia; Tromboembolism, Toxicity, Tension pneumothorax, Tamponade). Resuscitation in maternal cardiac arrest is mostly similar with non-pregnant patient resuscitation. There are several considerations need to be addressed in primary survey such as endotracheal tube 1 size smaller, supplemental O2 regardless of peripheral saturation, aggressive volume resuscitation, and uterine displacement to relieve compression of the IVC.Keywords: Maternal cardiac arrest; non-pregnant patient resuscitation

Perimortem Cesarean Section : As Resucitative Hysterotomy On Maternal Cardiac Arrest

Maternal cardiac arrest or maternal collaps is defined as an acute event involving the cardiorespiratory systems and/or brain, resulting in a reduced or absent consciousness level (and potentially death), at any stage in pregnancy and up to six weeks after delivery. Perimortem Cesarean Section (PCS) is performed either during maternal cardiac arrest or during impending maternal cardiac arrest toresuscitate mother and fetal. Current recommendations for maternal resuscitation include performance of the procedure following five minutes of unsuccessful cardiopulmonary resuscitation. The most common aetiology of maternal collaps was know as “4 H and 4 T” (Hypovolemia, Hypoxia, Hypo/Hyperkalemia,Hypothermia; Tromboembolism, Toxicity, Tension pneumothorax, Tamponade). Resuscitation in maternal cardiac arrest is mostly similar with non-pregnant patient resuscitation. There are several considerations need to be addressed in primary survey such as endotracheal tube 1 size smaller, supplemental O2 regardless of peripheral saturation, aggressive volume resuscitation, and uterine displacement to relieve compression of the IVC.Keywords: Maternal cardiac arrest; non-pregnant patient resuscitation

Antepartum Complications of Pregnancy

Pregnancy presents unique considerations and challenges to the critical care provider, including the physiologic adaptations to the pregnant state, recruitment and collaboration with a multidisciplinary care team, determination of fetal status, preparing for and managing cardiac arrest in pregnancy, and evaluation and management of diseases unique to pregnancy (including preeclampsia and acute fatty liver of pregnancy). This review contains 48 references, and 4 tables. Key words: acute fatty liver of pregnancy, maternal cardiac arrest, perimortem cesarean section, preeclampsia, pregnancy

Obstetric Emergencies (DRAFT)

An obstetric rapid response team (RRT) should ideally include the readily available presence of an obstetrician and a well-established system for escalation of care and management of the fetus where applicable. During the evaluation of an obstetric patient, the RRT team should be familiar with the unique changes in maternal pregnant physiology and their influence on the presentation and management of common maternal emergencies. Postpartum hemorrhage, pre-eclampsia related complications, and sepsis together form the bulk of causes for maternal RRT calls. The knowledge of, and competence with, left lateral displacement of the uterus and the timing and execution of perimortem cesarean section are essential during maternal cardiopulmonary resuscitation. In this chapter, we review common maternal emergencies during RRT activation and their management.