22 results match your criteria: "Labor and Delivery Perimortem Cesarean Delivery"

Cesarean section via a transverse uterine fundal incision is performed in patients with placenta previa to reduce blood loss. We describe a case of uterine rupture in a pregnant woman who previously underwent a cesarean section and recovered from cardiac arrest by multidisciplinary management.

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We report the successful salvage of mother and baby after a perimortem cesarean delivery (PMCD) complicated by a 21-minute asystolic maternal cardiac arrest (MCA) that was precipitated by a pulmonary embolism during the early stages of induction of labor. With rapid PMCD, recovery of maternal quality of life is possible even after prolonged resuscitation.

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Society for Maternal-Fetal Medicine Special Statement: Checklist for initial management of amniotic fluid embolism.

Am J Obstet Gynecol

April 2021

Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.

Amniotic fluid embolism is a rare syndrome characterized by sudden cardiorespiratory collapse during labor or soon after delivery. Because of its rarity, many obstetrical providers have no experience in managing amniotic fluid embolism and may therefore benefit from a cognitive aid such as a checklist. We present a sample checklist for the initial management of amniotic fluid embolism based on standard management guidelines.

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Article Synopsis
  • Cardiac arrest during pregnancy is uncommon and often not thoroughly covered in Advanced Cardiovascular Life Support courses, leading to knowledge gaps among healthcare providers, prompting the need for specialized training.
  • A multidisciplinary simulation involving anesthesia and maternal fetal medicine fellows, along with obstetric nurses, was conducted using a scenario of amniotic fluid embolism to train participants in cardiopulmonary resuscitation and perimortem cesarean delivery within a 5-minute window.
  • The training received positive feedback, improved self-confidence among participants, and identified systems issues that were addressed; however, increasing the frequency of these sessions remains challenging, with plans for broader training implementation.
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Anesthetic management of amniotic fluid embolism -- a multi-center, retrospective, cohort study.

J Matern Fetal Neonatal Med

April 2019

a Department of Anesthesia, and Sackler Faculty of Medicine , Rabin Medical Center, Beilinson Hospital, Petach Tikvah Israel, Tel Aviv University, Tel Aviv , Israel.

Introduction: Amniotic fluid embolism (AFE) is a rare and potentially lethal obstetric complication, commonly occurring during labor, delivery, or immediately postpartum. There is a paucity of data regarding incidence, risk factors, and clinical management. Our primary objective in this study was to evaluate clinical presentation of AFE and delineate anesthesia management of these cases.

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Cases: Perimortem cesarean delivery (PMCD) is the only way to resuscitate pregnant women in cardiac arrest, and has been found to increase maternal resuscitation rate by increasing circulating plasma volume. However, many obstetricians have not experienced a case of PMCD, as situations requiring it are rare. We report our strategy for cases of maternal cardiac arrest, on the basis of a review of published work, and present two case reports from our medical center.

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Article Synopsis
  • Perimortem caesarean sections can significantly impact the survival rates of both a mother and her fetus during a cardiac arrest in pregnancy.* -
  • In a documented case, a mother in early labor went into cardiac arrest, and a caesarean section performed seven minutes later successfully delivered a live baby.* -
  • The mother regained her heartbeat shortly after the delivery and made a full recovery, highlighting the critical nature of quick decision-making in such emergencies.*
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Article Synopsis
  • Physical trauma significantly impacts pregnant women, affecting 1 in 12, leading to serious maternal and fetal health complications, necessitating a multidisciplinary approach to care.
  • A systematic review of medical literature from various databases was conducted to develop evidence-based guidelines for managing trauma in pregnant patients, focusing on systematic reviews and controlled trials.
  • The document aims to provide obstetric care providers with practical guidelines to ensure consistent and effective care for trauma-affected pregnancies, despite limited evidence regarding certain interventions, like disabling airbags for pregnant women.
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Cardiopulmonary arrest is a rare event during pregnancy and labor. Perimortem cesarean section has been resorted to as a rare event since ancient times; however, greater awareness regarding this procedure within the medical community has only emerged in the past few decades. Current recommendations for maternal resuscitation include performance of the procedure after five minutes of unsuccessful cardiopulmonary resuscitation.

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Maternal cardiac arrest in a tertiary care centre during 1989-2011: a case series.

Can J Anaesth

November 2013

Department of Anesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada,

Purpose: To review and report maternal and neonatal outcomes after cardiac arrest during pregnancy in a large tertiary care centre and to consider steps to improve the outcomes.

Clinical Features: We performed a retrospective chart review of maternal cardiac arrest in the Mount Sinai Hospital, University of Toronto health records database for the period 1989-2011. Five cases were identified for an incidence of 1:24,883 deliveries (0.

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Cardiac arrest in an obstetric patient using remifentanil patient-controlled analgesia.

Anaesthesia

March 2013

The Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Article Synopsis
  • The case report discusses a patient who experienced an intrauterine death at 31 weeks of pregnancy and had a cardiorespiratory arrest during induced labor.
  • The patient was using a remifentanil patient-controlled analgesia (PCA) for pain management at the time of the incident.
  • After resuscitation efforts, which involved a peri-mortem cesarean section, the patient made a complete recovery.
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Background: The purpose of this study was to compare cardiopulmonary resuscitation (CPR) for simulated maternal cardiac arrest rendered during transport to the operating room with that rendered while stationary in the labor room. We hypothesized that the quality of CPR would deteriorate during transport.

Methods: Twenty-six teams composed of 2 providers (obstetricians, nurses, or anesthesiologists) were randomized to perform CPR on the Laerdal Resusci Anne SkillReporterâ„¢ mannequin during transport or while stationary.

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Maternal cardiac arrest: an overview.

J Perinat Neonatal Nurs

September 2012

Specialty Obstetrical Referral Clinic and Labor & Delivery, The Medical Center of Plano, Plano, TX 75075, USA.

Article Synopsis
  • Cardiac arrest during pregnancy is uncommon, but quick resuscitation is vital for both the mother and baby.
  • The approach to resuscitating a pregnant woman is different from standard adult protocols, requiring specialized care.
  • The article outlines the reasons behind maternal cardiac arrest, how to effectively perform CPR on pregnant women, and when to consider delivering the baby via perimortem cesarean section.
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Article Synopsis
  • This study reviewed 41 cases of maternal cardiac arrest at a hospital over a five-year period and found a low survival rate of 29%.
  • The leading causes of cardiac arrest identified were hemorrhagic shock, amniotic fluid embolism, and severe preeclampsia/eclampsia, with most emergencies occurring in hospital settings, particularly the operating room.
  • Perimortem caesarean sections were performed in some cases, leading to better outcomes for both mothers and infants compared to cases where it wasn't done, highlighting its potential importance in clinical practice.
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Cardiac arrest is a rare occurrence in pregnancy and may be related to obstetric or medical causes. Pregnancy is associated with profound physiologic changes that prepare the gravida for the challenges of labor and delivery, and resuscitation of the pregnant patient needs to take these changes into consideration. Cardiac output and plasma volume increase in pregnancy and distribute differently with the uterine circulation receiving approximately 17% of the total cardiac output.

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Objective: To compare the labor room and operating room for perimortem cesarean delivery during simulated maternal arrests occurring outside the operating room. We hypothesized transport to the operating room for perimortem cesarean delivery would delay incision and other important resuscitation milestones.

Methods: We randomized 15 teams composed of obstetricians, nurses, anesthesiologists, and neonatal staff to perform perimortem cesarean delivery in the labor room or operating room.

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[Resuscitation of a pregnant patient--don't hesitate to perform a perimortem caesarean section].

Ned Tijdschr Geneeskd

July 2011

Maasstad Ziekenhuis, locaties Zuider en Clara, Afd. Gynaecologie en Obstetrie, Rotterdam, the Netherlands.

Article Synopsis
  • Cardiac arrest during pregnancy is rare but can be life-threatening, as demonstrated by a case of a 26-year-old woman who suffered a cardiac arrest due to amniotic fluid embolism during labor induction.
  • A perimortem caesarean section was successfully performed within five minutes of the arrest, but the patient later experienced severe complications, including disseminated intravascular coagulation and massive hemorrhage, leading to a supravaginal hysterectomy.
  • Both mother and baby eventually recovered well and were discharged after 13 days, highlighting the need for medical personnel to be trained in pregnancy-specific resuscitation techniques, including the timely performance of perimortem caesarean sections.
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Effects on the fetus and newborn of maternal analgesia and anesthesia: a review.

Can J Anaesth

October 2004

Department of Anesthesia, University of Manitoba, Winnipeg, Manitoba, Canada.

Purpose: To review the effects of maternal anesthesia and analgesia on the fetus and newborn.

Methods: An on-line computerized search of Medline, Embase, and the Cochrane Collaboration via PubMed was conducted. English language articles were selected.

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Emergency delivery and perimortem C-section.

Emerg Med Clin North Am

August 2003

Department of Emergency Medicine, Health Science Center, Texas A&M University System, Temple, TX, USA.

The emergency department is a suboptimal location for delivery, and the greater prevalence of complicated presentations and emergency deliveries results in higher morbidity and mortality. Any woman greater than 20 weeks' gestation in labor is considered medically unstable and should be triaged quickly. Fetal viability occurs after 24 to 26 weeks' gestation.

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Emergency complications of labor and delivery.

Emerg Med Clin North Am

February 1994

Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, Illinois.

The care of the pregnant patient presenting to the emergency department with labor or delivery complications requires an understanding of signs and symptoms of disease for the maternal and fetal patient. This article reviews management of common labor and delivery complications that may occur in the emergency department. The management of premature labor, premature rupture of the membranes, emergency delivery procedure, resolution of shoulder dystocia, prolapsed umbilical cord, and perimortem cesarean section are discussed.

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Article Synopsis
  • Many pregnancies that seem normal can quickly become high-risk, especially when labor begins.
  • Emergency medical protocols should prioritize transporting expectant mothers to the labor and delivery unit as quickly as possible for better outcomes.
  • Emergency personnel must be ready for possible immediate deliveries and should know how to perform perimortem cesarean deliveries in critical situations to save both mother and baby.
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