Feb 13, 2012

Perimortem C-Section in maternal collapse

Read and learnt something new today.

Perimortem Caesarean Section should be undertaken for if gestation more than 20weeks with futile CPR for 4minutes, and to be performed by 5minutes of resuscitation. It should not be delayed by moving the woman, it should be performed where the resuscitation take place.

Before the C-Section procedure, if it can be done swiftly, a sonogram technician will conduct an ultrasound exam to evaluate the fetal growth and the site of the placenta. The result of the ultrasound exam will serve as a guide for the pediatric team and so that the surgery can be performed without any extra surprises.

Benefits of perimortem Caesarean Section includes
  • reduces oxygen consumption (no more oxygen consumption by fetoplacenta unit)
  • improves venous/cardiac output (no more aortocaval compression)
  • facilitates chest compression (allow heart compression through diaphragm*)
  • makes ventilation easier (no more diaphragmatic splinting, reduced progesterone: normalization of the increased tidal volume and minute respiration)
* After the delivery, place the hand behind the heart (with diaphragm closed) and compressing it against the posterior aspect of anterior chest wall. This improves cardiac output beyond that achieved with closed chest compressions.

this is the coolest - almost Matrix-like. watch 1:44 to 1:47, 2:45 to 2:48

Source: GTG56 Maternal collapse by RCOG, UK

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