Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T12:42:39.611Z Has data issue: false hasContentIssue false

12 - Life support in obstetrics

Published online by Cambridge University Press:  21 August 2009

Alexander Heazell  and
John Clift
By
Julian Chilvers
Alexander Heazell
Affiliation:
University of Manchester
John Clift
Affiliation:
City Hospital, Birmingham
Julian Chilvers
Affiliation:
Consultant, Anaesthetist, City Hospital, Sandwell and West Birmingham Hospitals, NHS Trust, Birmingham, UK
Get access

Summary

Cardiac arrest in pregnancy is an extremely rare occurrence. Effective resuscitation of the mother is the most effective way to optimise fetal outcome. Resuscitation attempts should follow the Resuscitation Council UK guidelines on advance life support; however, these need to be modified when dealing with a pregnant mother. The greatest chance for both mother and baby to survive during cardiac arrest is if the baby is delivered in order to relieve aortocaval compression. The incidence of perimortem CS in the UK is quoted as 1 in every 170,000 deliveries. The decision to proceed to perimortem caesarean section (CS) is dependent on gestation. Preparation for the perimortem CS should be made immediately on commencing resuscitation. It is recommended that a classical midline approach should be used to speed up the procedure as there is natural diastasis of the recti muscles in late pregnancy.

Keywords

cardiac arrestclassical midline approachobstetricsperimortem CSresuscitation council guidelinespregnancy
Type
Chapter
Information
Obstetrics for Anaesthetists , pp. 136 - 139
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rees, G. A. D. and Willis, B. A., Resuscitation in late pregnancy. Anaesthesia, 43 (1988), 347–9.Google Scholar
Confidential Enquiry into Maternal and Child Health, Why Mothers Die 2000–2002 – The Sixth Report of the Confidential Enquiries into Maternal Deaths in the UK (London: Royal College of Obstetricians and Gynaecologists Press, 2004).
Nanson, J., Elcock, D., Williams, M. and Deakin, C. D., Do physiological changes in pregnancy change defibrillation energy requirements?Br. J. Anaesth., 87 (2001), 237–9.Google Scholar
Whitley, M. and Irvine, L., Postmortem and perimortem Caesarean section: what are the indicators?J. R. Soc. Med., 93 (2000), 6–9.Google Scholar
Chen, H. F., Lee, C. N., Hwang, G. D.et al. Delayed maternal death after perimortem Caesarean section. Acta Obstet. Gynecol. Scand., 73 (1994), 939–41.Google Scholar
Lopez-Zeno, J. A., Carlo, W. A., O'Grady, J. P. and Fanaroff, A. A., Infant survival following delayed postmortem Caesarean delivery. Obstet. Gynecol., 76 (1990), 991–2.Google Scholar
Page-Rodriguez, A. and Sanchez, J. Ganzalez, Perimortem Caesarean section of twin pregnancy. Acad. Emerg. Med., 10 (1999), 1072–4.Google Scholar
American Heart Association, Supplement. Part 10.8: Cardiac arrest associated with pregnancy. Circulation, 112:IV (2005), 150–3.
Morris, S. and Stacey, M., ABC of resuscitation: resuscitation in pregnancy. BMJ, 327 (2003), 1277–9.Google Scholar
Nolan, J., Soar, J., Lockey, A., et al. (eds.) Adult Advance Life Support, 5th edn (London: Resuscitation Council (UK), 2005).

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×