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[创伤性心脏骤停心肺复苏期间的院前濒死剖宫产术:病例报告及经验教训]

[Prehospital perimortem cesarean section during cardiopulmonary resuscitation for traumatic cardiac arrest : Case report and lessons learned].

作者信息

Wolff Justus, Breuer Florian, von Kottwitz Konrad, Poloczek Stefan, Röschel Tom, Dahmen Janosch

机构信息

Charité Universitätsmedizin Berlin, Berlin, Deutschland.

Ärztliche Leitung Rettungsdienst Rheinisch-Bergischer Kreis, Amt für Feuerschutz und Rettungswesen, Bergisch Gladbach, Deutschland.

出版信息

Unfallchirurgie (Heidelb). 2023 Sep;126(9):727-735. doi: 10.1007/s00113-022-01220-w. Epub 2022 Aug 10.

DOI:10.1007/s00113-022-01220-w
PMID:35947175
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10449654/
Abstract

The following case report discusses the resuscitation of a pregnant woman in traumatic cardiac arrest after a fall from a height with consecutive resuscitative hysterotomy for maternal and fetal salvage. The report illustrates all lessons learned from critical appraisal amid new guideline recommendations and gives an overview of the published literature on the matter. Despite extensive resuscitation efforts, ultimately both the mother and the newborn were pronounced life extinct at the scene. Prehospital treatment of (traumatic) cardiac arrest in a pregnant patient as well as performing a perimortem cesarean section remain infrequent but challenging scenarios.

摘要

以下病例报告讨论了一名孕妇从高处坠落导致创伤性心脏骤停后的复苏情况,以及为挽救母婴而连续进行的复苏性子宫切开术。该报告阐述了在新的指南建议下通过批判性评估吸取的所有经验教训,并概述了关于此事的已发表文献。尽管进行了广泛的复苏努力,但最终母亲和新生儿均在现场被宣布死亡。对孕妇(创伤性)心脏骤停进行院前治疗以及实施濒死剖宫产仍然是罕见但具有挑战性的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8110/10449654/c6314584a3da/113_2022_1220_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8110/10449654/ef92190f4277/113_2022_1220_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8110/10449654/c6314584a3da/113_2022_1220_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8110/10449654/ef92190f4277/113_2022_1220_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8110/10449654/c6314584a3da/113_2022_1220_Fig2_HTML.jpg

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本文引用的文献

1
[Cardiopulmonary resuscitation of pregnant patients in the rescue service].[救援服务中孕妇的心肺复苏]
Notf Rett Med. 2022;25(5):359-368. doi: 10.1007/s10049-022-00979-0. Epub 2022 Feb 17.
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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.PRISMA 2020 声明:系统评价报告的更新指南。
BMJ. 2021 Mar 29;372:n71. doi: 10.1136/bmj.n71.
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European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances.欧洲复苏理事会 2021 指南:特殊情况下的心脏骤停。
Resuscitation. 2021 Apr;161:152-219. doi: 10.1016/j.resuscitation.2021.02.011. Epub 2021 Mar 24.
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[Indications, procedure and outcome of prehospital emergency resuscitative thoracotomy-a systematic literature search].[院前急诊复苏性开胸手术的适应症、操作及结果——一项系统文献检索]
Unfallchirurg. 2020 Sep;123(9):711-723. doi: 10.1007/s00113-020-00777-8.
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Prehospital Perimortem Caesarean Section - A Survivor.院外濒死产妇剖宫产术——一位幸存者。
Prehosp Emerg Care. 2020 Jul-Aug;24(4):595-599. doi: 10.1080/10903127.2019.1671563. Epub 2019 Oct 11.
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Two cases of low birth weight infant survival by prehospital emergency hysterotomy.两例通过院前急诊剖宫产实现低体重儿存活的病例。
Scand J Trauma Resusc Emerg Med. 2017 Jul 3;25(1):62. doi: 10.1186/s13049-017-0407-8.
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The CAPS Study: incidence, management and outcomes of cardiac arrest in pregnancy in the UK: a prospective, descriptive study.CAPS 研究:英国妊娠相关性心搏骤停的发生率、处理方法和结局:一项前瞻性描述性研究。
BJOG. 2017 Aug;124(9):1374-1381. doi: 10.1111/1471-0528.14521. Epub 2017 Feb 24.
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Maternal collapse: Challenging the four-minute rule.孕产妇心脏骤停:对四分钟规则的挑战。
EBioMedicine. 2016 Apr;6:253-257. doi: 10.1016/j.ebiom.2016.02.042. Epub 2016 Mar 2.
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Challenging the 4- to 5-minute rule: from perimortem cesarean to resuscitative hysterotomy.挑战 4-5 分钟规则:从濒死剖宫产到复苏性子宫切开术。
Am J Obstet Gynecol. 2015 Nov;213(5):653-6, 653.e1. doi: 10.1016/j.ajog.2015.07.019. Epub 2015 Jul 26.
10
Out-of-Hospital Perimortem Cesarean Section as Resuscitative Hysterotomy in Maternal Posttraumatic Cardiac Arrest.院外濒死剖宫产术作为创伤性心脏骤停产妇的复苏性子宫切开术
Case Rep Emerg Med. 2014;2014:121562. doi: 10.1155/2014/121562. Epub 2014 Oct 30.