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Cesarean Section, Emergency, Emergency Medicine

Jonathan B. Walker and James S. Walker Reviewed 06/2017
 


Basics

  • The sole indication for ED physician to perform emergency perimortem cesarean section is a gravid female (>24 wk gestation) in cardiopulmonary arrest who has not responded to initial resusci...

Diagnosis

Signs and Symptoms

History

Gravid female (>24 wk gestation determined by uterine fundal height) who is in cardiopulmonary arrest 

Physical Exam

Patient is determined to be >24 wk gestation...

Treatment

Pre-Hospital

Cautions: 
  • Minimal scene time, “scoop and run”

  • Place the patient in the left lateral decubitus position to avoid compression of inferior vena cava (supine hypotension syndrome)

  • Trau...

Follow-Up

Disposition

Admission Criteria

  • The infant should be admitted to NICU

  • If maternal resuscitation is successful, patient should be admitted to appropriate ICU

Discharge Criteria

Neither infant nor m...

Pearls and Pitfalls

  • Only females >24 wk pregnant in cardiopulmonary arrest qualify for the procedure.

  • Decision to perform perimortem cesarean section must be made quickly (within 4 min of maternal c...

Additional Reading

  • Atta  E, Gardner  M. Cardiopulmonary Resuscitation in Pregnancy. Obstet Gynecol Clin North Am.  2007;34(3):585–597.

  • Brown  HL. Trauma in pregnancy. Obstet Gynecol.  2009;11...

Codes

ICD9

  • 427.5 Cardiac arrest

  • 659.83 Other specified indications for care or intervention related to labor and delivery, antepartum condition or complication

ICD10

  • I46.9 Cardiac arrest, cause unspecifie...

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