Essentials in cardiac arrest during cesarean section.
Cardiac arrest during cesarean section is very rare. Obstetrical teams have low exposure to these critical situations necessitating frequent rehearsal and knowledge of its differential diagnosis and treatment. A 40-year-old woman pregnant with triplets underwent cesarean sections because of vaginal bleeding due to a placenta previa at 35.2 weeks of gestation. Spinal anesthesia was performed. Asystole occurred during uterotomy. Immediate resuscitation and delivery of the neonates eventually resulted in good maternal and neonatal outcomes. The differential diagnosis is essential and should include obstetric and non-obstetric causes. We describe the consideration of Bezold Jarisch reflex and amniotic fluid embolism as most appropriate in this case.
Department of Obstetrics and Gynecology; VU University Medical Center , Amsterdam, the Netherlands.
Susan W J D
SW
van Liempt
Department of Anesthesia, VU University Medical Center , Amsterdam, the Netherlands.
Katrin
K
Stoecklein
Department of Obstetrics and Gynecology; VU University Medical Center , Amsterdam, the Netherlands.
Ming Y
MY
Tjiong
Department of Anesthesia, VU University Medical Center , Amsterdam, the Netherlands.
Lothar A
LA
Schwarte
Department of Obstetrics and Gynecology; VU University Medical Center , Amsterdam, the Netherlands.
Christianne J M
CJ
de Groot
Department of Obstetrics and Gynecology; VU University Medical Center , Amsterdam, the Netherlands.
Pim W
PW
Teunissen
Bezold Jarisch reflex; cardiac arrest; cesarean section