Perimortem Caesarean Section - Every Second Counts! A Report of Two Cases

Perimortem Cesarean Section

  • Nalini Bala Pandey Consultant, Department of Obstetrics & Gynaecology, Lok Nayak Hospital, New Delhi, India.
  • Nitisha Verma Post Graduate Resident, Department of Obstetrics & Gynaecology, Maulana Azad Medical College, New Delhi, India.
  • Tripti Aneja Senior Resident, Department of Obstetrics & Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
  • Nidhi Chaudhary Senior Resident, Department of Obstetrics & Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
  • Sangeeta Bhasin Senior Consultant, Department of Obstetrics & Gynaecology, Lok Nayak Hospital, New Delhi, India.
  • Asmita M Rathore Director Professor and Head of the Department, Department of Obstetrics & Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
  • Abhishek Kumar Senior Resident, Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
  • Naresh Kumar Professor, Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
Keywords: Perimortem Caesarean Section (PMCS), Maternal Cardiac Arrest, Return of Spontaneous Circulation (ROSC), Hysterotomy

Abstract

Perimortem caesarean section (PMCS), also referred to as resuscitative hysterotomy, is a caesarean section done during maternal cardiac arrest with the ultimate goal to assist maternal resuscitation with a good foetal
outcome. Here, we present a report of two cases of PMCS performed in the setting of maternal cardiac arrest in a tertiary care hospital. Both the mothers had underlying cardiac disease and the cause of cardiac arrest was pulmonary embolism in first case and arrhythmia in the other. When there was no return of spontaneous circulation (ROSC) by 5 minutes of resuscitation, PMCS was done at the place of the cardiac arrest. The patients were made supine, left uterine displacement was done and cardio-pulmonary resuscitation (CPR) was continued. The abdomen and the uterus was opened by a scalpel via a midline vertical incision. The baby was handed over to the paediatrician. CPR was continued while the surgery was taking place. The mothers could
not be revived in any of the cases, but babies were resuscitated well and later discharged in healthy condition. Clinicians should be aware of the need of PMCS in case of cardiac arrest in pregnant women at or above 20 weeks of gestation.

How to cite this article:
Pandey NB, Verma N, Aneja T, Chaudhary N, Bhasin S, Rathore AM, Kumar A, Kumar N. Perimortem Caesarean Section - Every Second Counts! A Report of Two Cases. Int J Preven Curat Comm Med. 2021;7(3):22-25.

DOI: https://doi.org/10.24321/2454.325X.202114

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Published
2021-12-24