Case No. 62

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Case No. 62

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Chief Complaint:

Pregnant, Cardiac Arrest after an Accident

Published: July 24, 2017
Author: MarkSuguitan
CASE SCENARIO

A 21 year old pregnant female presents in cardiac arrest. EMS reports she was hit by a car and found unconscious at the seen without a pulse and CPR was performed. En route there was no return of spontaneous circulation. On exam, the uterus is approx. 8-9cm above the umbilicus, bedside sonogram shows fetal heart activity. You decide to perform a perimortem cesarean section.

QUESTION

What is correct regarding this emergent procedure?

  • A low, horizontal incision should be made
  • CPR should be stopped to allow for emergent incision
  • Resuscitation should continue for more than 10 minutes before perimortem cesarean section is considered in order to perfuse the fetus before the procedure
  • A large vertical skin incision should be made
  • The height of the uterine fundus is not related to predicted outcome
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