Case No. 62

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Case No. 62

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Chief Complaint:

Pregnant, Cardiac Arrest after an Accident

Published: July 24, 2017
Case No. 62
Author: MarkSuguitan
CASE SCENARIO

A 21 year old pregnant female presents in cardiac arrest. EMS reports she was hit by a car and found unconscious at the seen without a pulse and CPR was performed. En route there was no return of spontaneous circulation. On exam, the uterus is approx. 8-9cm above the umbilicus, bedside sonogram shows fetal heart activity. You decide to perform a perimortem cesarean section.

QUESTION

What is correct regarding this emergent procedure?

A low, horizontal incision should be made
CPR should be stopped to allow for emergent incision
Resuscitation should continue for more than 10 minutes before perimortem cesarean section is considered in order to perfuse the fetus before the procedure
A large vertical skin incision should be made
The height of the uterine fundus is not related to predicted outcome