title: [Emergency cesarean section].
abstract: There are abundant cases of obstetric emergencies demanding prompt intervention. Emergency cesarean sections are classified into stable, urgent and immediate surgeries, although there is significant overlap between three groups. Stable emergency cesarean sections are performed in patients with stable maternal and fetal physiology, but who need surgery before unstability occurs. Urgent cesarean sections refer to situations in which maternal and/or fetal physiology is unstable, whereas the immediate cesarean section is used for life-threatening condition such as sustained fetal bradycardia, maternal cardiopulmonary arrest. In most cases the key to proper management is the prompt communication between obstetricians and anesthesiologists. Anesthesiologists must have a clear understanding of certain obstetric emergencies. In the event of sustained fetal bradycardia caused by placental abruption, cord prolapse, uterine rupture etc, delivery by immediate cesarean section within 25 minutes improve long-term neonatal neurologic outcome. Although cardiopulmonary arrest in pregnancy is very uncommon, peripartum cesarean section should be considered within 5 minutes not only for maternal resuscitation but for neonatal survival. Only a well-coordinated teamwork of all involved specialities will guarantee optimal prognosis of mother and fetus.
authors.affiliation: Department of Obstetrics and Gynecology, Kitasato University Hospital, Sagamihara 252-0375.
authors.forename: Shoko
authors.initials: S
authors.lastname: Kawano
authors.forename: Kan
authors.initials: K
authors.lastname: Amano
authors.forename: Nobuya
authors.initials: N
authors.lastname: Unno
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Okutomi
mesh_terms: D000773:Anesthesia, Obstetrical; D002585:Cesarean Section / Q000145:classification; D004630:Emergencies; D004632:Emergency Medical Services; D005260:Female; D005323:Fetal Monitoring; D005333:Fetus / Q000098:blood supply; D006801:Humans; D007231:Infant, Newborn; D033183:Interdisciplinary Communication; D009422:Nervous System Diseases / Q000517:prevention & control; D010348:Patient Care Team; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors