Wu Szu-Hsin, Li Ryh-Sheng, Hwu Yuh-Ming
Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan.
Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2019 Jan;58(1):43-45. doi: 10.1016/j.tjog.2018.11.007.
The aim of this study is to share a valuable experience of perimortem Cesarean delivery (PMCD) when no signs of spontaneous circulation were detected after 4 min of resuscitation. The time interval between maternal cardiac arrest and neonatal delivery was evaluated and reviewed.
We present the case of an out-of-hospital cardiac arrest (OHCA) in a nulliparous woman who survived a car accident with only seatbelt injuries. The term infant was delivered by PMCD at our emergency department at least 43 min after maternal cardiac arrest. The mother only had concussion and was healthy at the time of discharge. The infant survived but had moderate neurological growth impairment (cerebral palsy) at the age of 7 months.
Contrary to previous studies and case reports, maternal and neonatal outcomes seem to be better when performing PMCD within 10 min. Multidisciplinary teamwork is the key for optimal outcomes in such situations.
本研究旨在分享复苏4分钟后未检测到自主循环迹象时进行濒死剖宫产（PMCD）的宝贵经验。评估并回顾了母亲心脏骤停与新生儿分娩之间的时间间隔。
我们呈现了一名初产妇院外心脏骤停（OHCA）的病例，该产妇在车祸中仅受安全带伤后存活。足月婴儿在母亲心脏骤停至少43分钟后于我们的急诊科通过PMCD分娩。母亲仅有脑震荡，出院时身体健康。婴儿存活，但在7个月大时出现中度神经发育障碍（脑瘫）。
与先前的研究和病例报告相反，在10分钟内进行PMCD时，母婴结局似乎更好。多学科团队合作是此类情况下实现最佳结局的关键。
