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Cardiac arrest due to postpartum hemorrhage may not respond well to traditional resuscitation techniques, prompting consideration of alternative methods like sternotomy or ECMO.
A case study detailed a woman who experienced severe hemorrhage after a cesarean delivery, leading to cardiac arrest that did not improve for two hours before ECMO was started.
The successful use of ECMO suggests that aggressive mechanical support may be crucial for young obstetric patients facing serious circulatory issues.
Article Abstract
Background: Cardiac arrest after postpartum hemorrhage may not respond to advanced life support. Various resuscitation methods have been proposed, including sternotomy and direct cardiac massage. Extracorporeal membrane oxygenation (ECMO) might be an alternative.
Case: We report the case of a woman who suffered atonic uterine hemorrhage perioperatively after cesarean delivery of twins. During initial conservative treatment using prostaglandin analog (sulprostone), cardiac decompensation developed and was followed by cardiopulmonary arrest. Circulatory failure remained unresponsive after 2 hours of resuscitation, when ECMO was initiated. The ensuing recovery was favorable.
Conclusion: Aggressive mechanical circulatory support, such as ECMO, should be considered in a case of potentially reversible cardiocirculatory failure in a young obstetric patient.
