title: A report of fetal demise during therapeutic hypothermia after cardiac arrest.
abstract: BACKGROUND
  Therapeutic hypothermia is becoming the standard-of-care for coma following out-of-hospital cardiac arrest. Pregnancy has been considered a contraindication for therapeutic hypothermia.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 44-year-old woman presented after a witnessed out-of-hospital ventricular fibrillation cardiac arrest. She remained comatose upon hospital admission and was treated with induced hypothermia via surface cooling pads. An intrauterine pregnancy of 20 weeks gestation was discovered on admission. One day after admission, a stillborn fetus was spontaneously delivered. The patient made a good neurologic recovery and now lives at home with her family.
  
  
  CONCLUSIONS
  During pregnancy, beneficence toward the pregnant woman must be the primary ethical guideline in emergent, life-threatening situations. Pregnancy should not be a contraindication to therapeutic hypothermia following cardiac arrest.
authors.affiliation: Department of Medicine, Duke University Medical Center, DUMC Box 2900, Durham, NC 27710, USA. elissa.wible@gmail.com
authors.forename: Elissa Fory
authors.initials: EF
authors.lastname: Wible
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Kass
authors.forename: George A
authors.initials: GA
authors.lastname: Lopez
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000401:mortality*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000401:mortality*; D011247:Pregnancy; D050497:Stillbirth