scholarly journals Cardiac arrest in pregnancy and perimortem cesarean delivery: case report and discussion

CJEM ◽  
2011 ◽  
Vol 13 (06) ◽  
pp. 399-403 ◽  
Author(s):  
Paul T. Engels ◽  
Sheila C. Caddy ◽  
Gulnaz Jiwa ◽  
J. Douglas Matheson
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Cesarean Delivery ◽  
Vena Cava ◽  
Pregnant Patient ◽  
Gravid Uterus ◽  
Severe Hypoxemia ◽  
Successful Resuscitation ◽  
Emergency Department Setting ◽  
In Pregnancy

ABSTRACT Cardiac arrest in pregnancy is a rare occurrence, particularly in the emergency department setting. The resuscitation of a pregnant patient in cardiac arrest is unique in a number of ways. Early identification and treatment of possible etiologies, appropriate response to the physiologic changes present in pregnancy, relief of potential vena cava obstruction by the gravid uterus, and expeditious preparation for possible cesarean delivery are important considerations for a successful resuscitation. We report and discuss the case of a pregnant patient with pulmonary edema and cardiac dysfunction who presented with severe hypoxemia and subsequent cardiac arrest and underwent a perimortem cesarean delivery and simultaneous fetal and maternal resuscitation in the emergency department.

scholarly journals Peritoneovaginal Fistula and Appendicitis-Related Pelvic Abscess in Pregnancy

2020 ◽  
Vol 10 (02) ◽  
pp. e129-e132
Author(s):  
Mona Saleh ◽  
Antonia Francis Kim ◽  
Andrew Gardner ◽  
Katherine Sun ◽  
Sara Brubaker
Keyword(s):  
Pregnant Patient ◽  
Pelvic Abscess ◽  
Acute Onset ◽  
Gravid Uterus ◽  
Second Trimester ◽  
Appendiceal Abscess ◽  
Speculum Examination ◽  
Complete Physical Examination ◽  
Criteria For Diagnosis ◽  
In Pregnancy

AbstractAppendicitis in pregnancy is the most common nonobstetric surgical emergency. Pregnancy causes changes in anatomy, which could lead to uncertainty regarding the diagnosis of appendicitis. This case report describes a case of appendicitis presenting with peritoneovaginal fistula in a pregnant woman in the second trimester, with interesting finding of isolated appendiceal endometriosis on pathology. The importance of complete physical examination, including speculum examination, is emphasized in the pregnant patient presenting with acute-onset abdominal pain. Imaging criteria for diagnosis of appendicitis should be adjusted to account for the gravid uterus, which may cause appendiceal abscess to appear in a variety of locations, such as posterior to the cervix, as in this case.

scholarly journals Care of the Critically Ill Pregnant Patient and Perimortem Cesarean Delivery in the Emergency Department

2016 ◽  
Vol 51 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Megan E. Healy ◽  
Dana E. Kozubal ◽  
Amanda E. Horn ◽  
Gary M. Vilke ◽  
Theodore C. Chan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cesarean Delivery ◽  
Critically Ill ◽  
Pregnant Patient

scholarly journals Challenges of Cardiopulmonary Resuscitation during Pregnancy

2019 ◽  
Vol 04 (01) ◽  
pp. 032-039
Author(s):  
Padmaja Durga ◽  
Shibani Padhy ◽  
Anupama Bardaa
Keyword(s):  
Cardiac Arrest ◽  
Pregnant Woman ◽  
Cardiopulmonary Resuscitation ◽  
Cricoid Pressure ◽  
Cardiopulmonary Arrest ◽  
Vena Cava ◽  
Spontaneous Circulation ◽  
Gravid Uterus ◽  
Rapid Sequence Intubation ◽  
Team Approach

AbstractCardiac arrest, though rare, is the most feared complication in the pregnant woman as it involves two lives. Most arrests occur because of conditions that result from the pregnancy itself or from preexisting medical conditions exacerbated by the pregnancy. Prompt resuscitative efforts are crucial for favorable outcomes for the mother and fetus. The basic principles of resuscitation during pregnancy such as airway, breathing, and circulation are similar to the resuscitation in a cardiopulmonary arrest in any patient; however, certain modifications are necessary to account for the physiologic changes that occur during the pregnancy. Cardiopulmonary resuscitation (CPR) of the parturient should include uterine tilt or displacement to relieve the compression of the inferior vena cava and aorta by the gravid uterus, intubation using rapid sequence intubation with cricoid pressure, and timely perimortem cesarean section (PMCS). Ideally, the PMCS must be performed within 5 minutes of cardiac arrest if the pregnant woman does not have a return of spontaneous circulation, and resuscitation is deemed unsuccessful. The PMCS is performed if the gestational age is at least 20 weeks or the gravid uterus is evident. A high-quality CPR and multispecialty team approach, consisting of obstetricians, cardiologists, anesthesiologists, neonatologists, and nursing staff, is essential for survival.

scholarly journals Obstructed uterine venous return: a preventable cause of dysfunctional labor?

Reproduction ◽  
2021 ◽  
Vol 161 (4) ◽  
pp. V15-V17
Author(s):  
Thomas L Archer
Keyword(s):  
Inferior Vena Cava ◽  
Abdominal Wall ◽  
Cesarean Delivery ◽  
Inferior Vena ◽  
Venous Return ◽  
Vena Cava ◽  
Gravid Uterus ◽  
Common Cause ◽  
Dysfunctional Labor

Dysfunctional labor is a common cause of cesarean delivery and may be caused by myometrial hypoxia. Obstruction of uterine venous return due to compression of the inferior vena cava by the gravid uterus or the abdominal wall may be an auxiliary cause of myometrial hypoxia which aggravates other causes.

Safety and feasibility of nasopharyngeal evaporative cooling in the emergency department setting in survivors of cardiac arrest

Resuscitation ◽  
2010 ◽  
Vol 81 (8) ◽  
pp. 943-949 ◽  
Author(s):  
H.-J. Busch ◽  
F. Eichwede ◽  
M. Födisch ◽  
F.S. Taccone ◽  
G. Wöbker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Evaporative Cooling ◽  
Emergency Department Setting

scholarly journals Perimortem Cesarean Section : As Resucitative Hysterotomy On Maternal Cardiac Arrest

2020 ◽  
Vol 4 (2) ◽  
pp. 218-230
Author(s):  
Madona Utami Dewi ◽  
Syahredi Syaiful Adnani ◽  
Emilzon Taslim
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cesarean Section ◽  
Tension Pneumothorax ◽  
Pregnant Patient ◽  
Volume Resuscitation ◽  
Consciousness Level ◽  
Perimortem Cesarean Section ◽  
Acute Event ◽  
In Pregnancy

Maternal cardiac arrest or maternal collaps is defined as an acute event involving the cardiorespiratory systems and/or brain, resulting in a reduced or absent consciousness level (and potentially death), at any stage in pregnancy and up to six weeks after delivery. Perimortem Cesarean Section (PCS) is performed either during maternal cardiac arrest or during impending maternal cardiac arrest toresuscitate mother and fetal. Current recommendations for maternal resuscitation include performance of the procedure following five minutes of unsuccessful cardiopulmonary resuscitation. The most common aetiology of maternal collaps was know as “4 H and  4 T” (Hypovolemia, Hypoxia, Hypo/Hyperkalemia,Hypothermia; Tromboembolism, Toxicity, Tension pneumothorax, Tamponade). Resuscitation in maternal cardiac arrest is mostly similar with non-pregnant patient resuscitation. There are several considerations need to be addressed in primary survey such as endotracheal tube 1 size smaller, supplemental O2 regardless of peripheral saturation, aggressive volume resuscitation, and uterine displacement to relieve compression of the IVC.Keywords: Maternal cardiac arrest; non-pregnant patient resuscitation

Obstetric Life Support

2017 ◽  
Author(s):  
Nathaniel N. Hsu ◽  
Richard C. Month
Keyword(s):  
Cardiac Arrest ◽  
Healthcare Provider ◽  
Life Support ◽  
Pregnant Patient ◽  
Advanced Cardiac Life Support ◽  
Response Team ◽  
Provider Knowledge ◽  
In Pregnancy

Although rare, cardiac arrest during pregnancy poses unique challenges to the code response team, including both physiologic changes as well as the concern for two patients: the mother and fetus. Enhanced healthcare provider knowledge of important changes for resuscitation of the pregnant patient may be needed. Thus, this chapter serves to educate providers on most common etiologies for cardiac arrest in pregnancy as well as the key modifications to current advanced cardiac life support (ACLS) protocol according to the recent 2010 AHA guidelines on resuscitation of the pregnant patient in cardiac arrest.

scholarly journals P003: Which factors predict resuscitation outcomes in patients arriving to the emergency department in cardiac arrest? A SHoC series study

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S57-S58
Author(s):  
P. Atkinson ◽  
N. Beckett ◽  
D. Lewis ◽  
J. Fraser ◽  
A. Banerjee ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Electrical Activity ◽  
Odds Ratio ◽  
Cardiac Rhythm ◽  
Point Of Care ◽  
Pulseless Electrical Activity ◽  
Spontaneous Circulation ◽  
Point Of Care Ultrasound ◽  
Successful Resuscitation

Introduction: The decision as to whether to end resuscitation for pre-hospital cardiac arrest (CA) patients in the field or in the emergency department (ED) is commonly made based upon standard criteria. We studied the reliability of several easily determined criteria as predictors of resuscitation outcomes in a population of adults in CA transported to the ED. Methods: A retrospective database and chart analysis was completed for patients arriving to a tertiary ED in cardiac arrest, between 2010 and 2014. Patients were excluded if aged under 19. Multiple data were abstracted from charts using a standardized form. Regression analysis was used to compare criteria that predicted return of spontaneous circulation (ROSC) and survival to hospital admission (SHA). Results: 264 patients met the study inclusion criteria. Logistic regression was used to identify predictors of ROSC and SHA. The criteria that emerged as significant predictors for ROSC included; longer ED resuscitation time (Odds ratio 1.11 (1.06- 1.18)), witnessed arrest (Odds ratio 9.43 (2.58- 53.0)) and having an initial cardiac rhythm of Pulseless Electrical Activity (Odds Ratio 3.23 (1.07-9.811)) over Asystole. Receiving point of care ultrasound (PoCUS; Odds ratio 0.22 (0.07-0.69)); and having an initial cardiac rhythm of Pulseless Electrical Activity (Odds Ratio 4.10 (1.43-11.88)) were the significant predictors for SHA. Longer times for ED resuscitation was close to reaching significance for predicting SHA Conclusion: Our results suggest that both fixed and adaptable factors, including increasing resuscitation time, and PoCUS use in the ED were important independent predictors of successful resuscitation. Several commonly used criteria were unreliable predictors.

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