Delayed maternal death after perimortem cesarean section.
We report a case of perimortem cesarean section performed on a multigravida with congestive heart failure. This patient had a past history of repeated episodes of acute myocarditis and this time, congestive heart failure attacked her at the 36th week of gestation. The maternal condition deteriorated rapidly with frequent attacks of ventricular fibrillation and cardiac arrest, which gradually became unresponsive to active cardio-pulmonary resuscitation (CPR). The fetal condition also worsened accordingly. Cesarean section was therefore performed and a 2590 gm depressed female baby was delivered in less than one minute after skin incision and about twenty-seven minutes after the maternal condition became extremely unstable. The Apgar scores were 1 at one min, 4 at five min and 6 at ten min. The mother improved soon after delivery of the fetus and her consciousness returned. However, her condition deteriorated again and she died four hours after operation. The fetus survived and follow-up 21 months after delivery was normal.
Chen
H F
HF
Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University and the Hospital, Taipei.
Lee
C N
CN
Huang
G D
GD
Hsieh
F J
FJ
Huang
S C
SC
Chen
H Y
HY
D000328:Adult; D002585:Cesarean Section; D017809:Fatal Outcome; D005260:Female; D005318:Fetal Heart / Q000502:physiology; D005323:Fetal Monitoring; D006323:Heart Arrest / Q000209:etiology; D006333:Heart Failure / Q000150:complications; D006801:Humans; D009205:Myocarditis / Q000150:complications; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality; D011256:Pregnancy Outcome; D014693:Ventricular Fibrillation / Q000150:complications