Role of peripartum cesarean section in maternal collapse in pregnancy

Abstract

Fortunately, maternal cardiopulmonary arrest is an uncommon complication in the field of obstetrics, nevertheless dreaded by the clinicians. Perimortem cesarean section (PMCS), if performed in a timely manner, not only improves the chances of fetal survival but also improves the success rates of maternal resuscitation. In pregnant women over 20 weeks of gestation, if there is no response to correctly performed cardiopulmonary resuscitation within 4 min of maternal collapse or if resuscitation is required to be continued beyond this time, then perimortem cesarean section should be undertaken to assist maternal resuscitation. Delivery of the fetus and placenta reduces oxygen consumption and improves venous return and cardiac output, facilitates chest compressions, and makes ventilation easier. PMCS should be considered a resuscitative procedure, to be performed primarily in the interests of maternal survival. Delivery within 5 min of maternal collapse improves the chances of survival for the baby. A case of maternal collapse due to cardiac tamponade with aortic dissection where a live baby was delivered by perimortem cesarean section is described.