van Liempt Susan W J D, Stoecklein Katrin, Tjiong Ming Y, Schwarte Lothar A, de Groot Christianne J M, Teunissen Pim W
Department of Obstetrics and Gynecology; VU University Medical Center , Amsterdam, the Netherlands.
Department of Anesthesia, VU University Medical Center , Amsterdam, the Netherlands.
Clin Pract. 2015 Feb 17;5(1):668. doi: 10.4081/cp.2015.668. eCollection 2015 Jan 28.
Cardiac arrest during cesarean section is very rare. Obstetrical teams have low exposure to these critical situations necessitating frequent rehearsal and knowledge of its differential diagnosis and treatment. A 40-year-old woman pregnant with triplets underwent cesarean sections because of vaginal bleeding due to a placenta previa at 35.2 weeks of gestation. Spinal anesthesia was performed. Asystole occurred during uterotomy. Immediate resuscitation and delivery of the neonates eventually resulted in good maternal and neonatal outcomes. The differential diagnosis is essential and should include obstetric and non-obstetric causes. We describe the consideration of Bezold Jarisch reflex and amniotic fluid embolism as most appropriate in this case.
剖宫产术中心脏骤停非常罕见。产科团队很少遇到这些危急情况，因此需要经常演练，并了解其鉴别诊断和治疗方法。一名怀有三胞胎的40岁女性，因妊娠35.2周前置胎盘导致阴道出血而接受剖宫产。采用了脊髓麻醉。子宫切开术期间发生了心搏停止。立即进行复苏并娩出新生儿，最终母婴结局良好。鉴别诊断至关重要，应包括产科和非产科原因。我们认为在这种情况下，贝佐尔德-雅里什反射和羊水栓塞是最恰当的考虑因素。
