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12 - Life support in obstetrics

Published online by Cambridge University Press:  21 August 2009

Alexander Heazell  and
John Clift
By
Julian Chilvers
Alexander Heazell
Affiliation:
University of Manchester
John Clift
Affiliation:
City Hospital, Birmingham
Julian Chilvers
Affiliation:
Consultant, Anaesthetist, City Hospital, Sandwell and West Birmingham Hospitals, NHS Trust, Birmingham, UK
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Summary

Cardiac arrest in pregnancy is an extremely rare occurrence. Effective resuscitation of the mother is the most effective way to optimise fetal outcome. Resuscitation attempts should follow the Resuscitation Council UK guidelines on advance life support; however, these need to be modified when dealing with a pregnant mother. The greatest chance for both mother and baby to survive during cardiac arrest is if the baby is delivered in order to relieve aortocaval compression. The incidence of perimortem CS in the UK is quoted as 1 in every 170,000 deliveries. The decision to proceed to perimortem caesarean section (CS) is dependent on gestation. Preparation for the perimortem CS should be made immediately on commencing resuscitation. It is recommended that a classical midline approach should be used to speed up the procedure as there is natural diastasis of the recti muscles in late pregnancy.

Keywords

cardiac arrestclassical midline approachobstetricsperimortem CSresuscitation council guidelinespregnancy
Type
Chapter
Information
Obstetrics for Anaesthetists , pp. 136 - 139
Publisher: Cambridge University Press
Print publication year: 2008

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References

Rees, G. A. D. and Willis, B. A., Resuscitation in late pregnancy. Anaesthesia, 43 (1988), 347–9.Google Scholar
Confidential Enquiry into Maternal and Child Health, Why Mothers Die 2000–2002 – The Sixth Report of the Confidential Enquiries into Maternal Deaths in the UK (London: Royal College of Obstetricians and Gynaecologists Press, 2004).
Nanson, J., Elcock, D., Williams, M. and Deakin, C. D., Do physiological changes in pregnancy change defibrillation energy requirements?Br. J. Anaesth., 87 (2001), 237–9.Google Scholar
Whitley, M. and Irvine, L., Postmortem and perimortem Caesarean section: what are the indicators?J. R. Soc. Med., 93 (2000), 6–9.Google Scholar
Chen, H. F., Lee, C. N., Hwang, G. D.et al. Delayed maternal death after perimortem Caesarean section. Acta Obstet. Gynecol. Scand., 73 (1994), 939–41.Google Scholar
Lopez-Zeno, J. A., Carlo, W. A., O'Grady, J. P. and Fanaroff, A. A., Infant survival following delayed postmortem Caesarean delivery. Obstet. Gynecol., 76 (1990), 991–2.Google Scholar
Page-Rodriguez, A. and Sanchez, J. Ganzalez, Perimortem Caesarean section of twin pregnancy. Acad. Emerg. Med., 10 (1999), 1072–4.Google Scholar
American Heart Association, Supplement. Part 10.8: Cardiac arrest associated with pregnancy. Circulation, 112:IV (2005), 150–3.
Morris, S. and Stacey, M., ABC of resuscitation: resuscitation in pregnancy. BMJ, 327 (2003), 1277–9.Google Scholar
Nolan, J., Soar, J., Lockey, A., et al. (eds.) Adult Advance Life Support, 5th edn (London: Resuscitation Council (UK), 2005).

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