Lightning Learning: Perimortem C-section
““Perimortem C-section is an emergency surgical procedure performed on a pregnant woman in cardiac arrest in order to save her life.””
What?
Perimortem C-section is an emergency surgical procedure performed on a pregnant woman in cardiac arrest.
Performed if a woman is obviously pregnant with palpable uterus and preferably within 4 minutes of cardiac arrest (can be within 10-15 but chances of fetal survival drops).
Some sources say the foetus should be 24 weeks – the uterus will be 3-4cm above the umbilicus.
Vertical incision is made from xiphoid to pubis, then a vertical incision is made in the uterus to deliver the baby
How?
Attempt is to save mum’s life:
Redirects blood flow from placenta
Relieves pressure from IVC
Improves ventilation
Attempt to save the baby by delivering as soon after cardiac arrest as possible.
Speed is more important than sterility. And remember to prepare for 2 patients, therefore – 2x bed spaces, 2x team members, and 2x equipment!
Further Reading
- St. Emlyn's: Perimortem C-section
- Medscape: Perimortem Cesarean Delivery
- Core EM: Peri-Mortem C-Section
