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12 - Life support in obstetrics
- By Julian Chilvers, Consultant, Anaesthetist, City Hospital, Sandwell and West Birmingham Hospitals, NHS Trust, Birmingham, UK
Alexander Heazell, University of Manchester, John Clift
Book:

Obstetrics for Anaesthetists

Published online:

21 August 2009

Print publication:

06 March 2008, pp 136-139
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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.