title: Cesarean section in a severely traumatized patient.
abstract: Massive trauma in a near-term pregnant patient challenges the emergency physician with very difficult treatment choices. We present the case of a severely traumatized pregnant female, near term, in whom the decision to proceed with a perimortem cesarean section in the Emergency Department produced a viable infant. We discuss the guidelines that are used in making such a decision and their rationale. The physiologic changes of pregnancy that may complicate maternal assessment and the effect of shock on the fetus are also discussed.
authors.affiliation: Emergency Medical Services, Medical Center of Delaware.
authors.forename: A R
authors.initials: AR
authors.lastname: LeSher
authors.forename: R E
authors.initials: RE
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D001238:Asphyxia Neonatorum / Q000209:etiology; D001926:Brain Death / Q000175:diagnosis; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009104:Multiple Trauma / Q000601:surgery*; D010348:Patient Care Team; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011263:Pregnancy Trimester, Third