Maternal cardiac arrest is a low-frequency, high-risk pregnancy complication with 2 lives at stake. Incidence is approximately 1 in 12,000 to 50,000 pregnancies with a greater than 40% mortality rate. Understanding physiologic changes of pregnancy and how to perform a perimortem cesarean section (resuscitative hysterotomy) are critical aspects of caring for maternal cardiac arrest. ALiEM Cards: Maternal Cardiac Arrest, written by Drs. Jeffrey Sakamoto, Collin Michels, Nikita Joshi, and Rebecca Bavolek, reviews the causes, management pearls, and summarizes the perimortem cesarean delivery.
Pearl
The gestational age cutoff at which a perimortem cesarean section is 24 weeks per the 2005 EAST guidelines based on low level evidence.1
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1.
Barraco RD, Chiu WC, Clancy TV, et al. Practice Management Guidelines for the Diagnosis and Management of Injury in the Pregnant Patient: The EAST Practice Management Guidelines Work Group.
T. 2010;69(1):211-214. doi:
10.1097/ta.0b013e3181dbe1ea Author information
ALiEM Cards Lead Developer
2015-16 ALiEM-AgileMD Design Fellow
Attending Physician
St. Mark's Hospital
Salt Lake City, UT
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