title: [Resuscitation of a pregnant patient--don't hesitate to perform a perimortem caesarean section].
abstract: Cardiac arrest is a rare and life-threatening complication during pregnancy. We present the case of a 26-year-old patient in her first pregnancy who during induction of labour at 41 weeks had a cardiac arrest caused by an amniotic fluid embolism. As part of the resuscitation procedure, a perimortem caesarean section was performed in the delivery room within five minutes. Following the caesarean section, she developed diffuse intravascular coagulation and massive, life-threatening haemorrhage which necessitated supravaginal uterus amputation. Afterwards mother and son recovered well and were discharged from hospital in good condition after 13 days. Pregnancy-induced changes in anatomy and physiology warrant a different approach during resuscitation. All medical personnel involved in the care of pregnant women should be trained to act promptly in acute situations. Training should increase knowledge of the aforementioned changes and stress the importance of performing a perimortem caesarean section, when necessary, on site and without hesitation.
authors.affiliation: Maasstad Ziekenhuis, locaties Zuider en Clara, Afd. Gynaecologie en Obstetrie, Rotterdam, the Netherlands. w.vandorp@erasmusmc.nl
authors.forename: Wendy
authors.initials: W
authors.lastname: van Dorp
authors.forename: Iscander M
authors.initials: IM
authors.lastname: Maissan
authors.forename: Lorenz R R
authors.initials: LR
authors.lastname: Hapa
authors.forename: Johan W
authors.initials: JW
authors.lastname: Creemers
authors.forename: Jolise E
authors.initials: JE
authors.lastname: van Muyden-Martens
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation; D002585:Cesarean Section; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000628:therapy*; D004619:Embolism, Amniotic Fluid / Q000209:etiology / Q000628:therapy; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D016896:Treatment Outcome