User:Mr. Ibrahem/Resuscitative hysterotomy
| Mr. Ibrahem/Resuscitative hysterotomy | |
|---|---|
 A baby being removed from its dying mother's womb. Reproduction of woodcut, 1483. | |
| Other names | Perimortem Caesarean section (PMCS), perimortem Caesarean delivery (PMCD) |
| Specialty | Obstetrics, emergency medicine |
| Complications | Bladder injury, injury to the baby[1] |
A resuscitative hysterotomy, also referred to as a perimortem Caesarean section (PMCS), is a hysterotomy performed to resuscitate a pregnant women in cardiac arrest.[4] To be indicated the size of the uterus should be above the belly button.[3] The procedure removes the baby and thereby removes compression of the aorta and inferior vena cava.[4] This improves the mother's chances of survival, and may potentially also deliver a live baby.[4]
The procedure should be started within 4 minutes of a women's heart stopping.[3] A vertical cut is made from the top of the uterus to the level of the pubic bone.[3] Retractors are used to hold the area open and the bladder is pushed down.[3] A small vertical cut is than made through the lower part of the uterus and blunt tipped scissors are used to extend it up.[3] The baby is than removed, has its airway suctions, and the cord clamped.[3]
The chance of the baby surviving is as high as 70%.[1] The procedure is rarely done as cardiac arrest only occurs in about 1 in 30,000 pregnancies.[5] It may be performed by an obstetrician, emergency physician, or surgeon.[2][6] While the procedure has been described for 1,000s of years, documented cases of babies surviving began to occur in the late 1800s and mother surviving in the late 1900s.[7]
References[edit]
- ^ a b Alexander, AM; Sheraton, M; Lobrano, S (January 2021). "Perimortem Cesarean Delivery". PMID 30480973.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b Parry R, Asmussen T, Smith JE (Mar 2015). "Perimortem caesarean section". Emergency Medicine Journal. 33 (3). BMJ Group (published 2015-02-24): 224–229. doi:10.1136/emermed-2014-204466. PMID 25714106.
- ^ a b c d e f g Roberts and Hedges' clinical procedures in emergency medicine and acute care (Seventh ed.). Philadelphia, PA: Elsevier Health Sciences. 2019. pp. 1207–1210. ISBN 9780323547949.
- ^ a b c Rose CH, Faksh A, Traynor KD, Cabrera D, Arendt KW, Brost BC (Nov 2015). "Challenging the 4- to 5-minute rule: from perimortem cesarean to resuscitative hysterotomy". American Journal of Obstetrics and Gynecology. 213 (5). Elsevier (published 2015-07-26): 653–6, 653.e1. doi:10.1016/j.ajog.2015.07.019. PMID 26212180.
- ^ Krywko, DM; Sheraton, M; Presley, B (January 2021). "Perimortem Cesarean". PMID 29083739.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Jeejeebhoy FM, Zelop CM, Lipman S, Carvalho B, Joglar J, Mhyre JM, Katz VL, Lapinsky SE, Einav S, Warnes CA, Page RL, Griffin RE, Jain A, Dainty KN, Arafeh J, Windrim R, Koren G, Callaway CW (Nov 2015). "Cardiac Arrest in Pregnancy: A Scientific Statement From the American Heart Association". Circulation. 132 (18). Dallas, Texas: American Heart Association: 1747–73. doi:10.1161/CIR.0000000000000300. PMID 26443610.
- ^ "Perimortem Cesarean Delivery: Overview, Technique, Preparation". Medscape. 27 August 2020. Retrieved 20 March 2021.