Porntipa Tantibundit1, Manasicha Mekjarasnapha2, Aksorn Pulnitiporn3, Adhus Jirasavetakul4. 1. Division of Critical Care Medicine, Department of Emergency Medicine, Khon Kaen Hospital, Khon Kaen, Thailand. 2. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Khon Kaen Hospital, Khon Kaen, Thailand. 3. Department of Anesthesiology, Khon Kaen Hospital, Khon Kaen, Thailand. 4. Division of Cardiothoracic Surgery, Department of Surgery, Khon Kaen hospital, Khon Kaen, Thailand.
Abstract
INTRODUCTION: Maternal cardiac arrest is a rare condition. Cardiopulmonary resuscitation (CPR) in pregnancy is different from that in other populations due to physiological changes in patients. Extracorporeal cardiopulmonary resuscitation (ECPR) is recommended in patients having cardiac arrest with potentially reversible etiologies. However, data regarding ECPR in pregnancy are limited. CASE SUMMARY: A 24-year-old woman with a 33-week twin pregnancy developed witnessed cardiac arrest in an antenatal clinic. She underwent perimortem cesarean delivery (PMCD) and ECPR, but uterine atony with massive bleeding occurred. Emergency hysterectomy and massive blood transfusion were performed in the emergency department and the patient was transferred to the intensive care unit after hemodynamics was stable. CONCLUSION: Cardiac arrest in pregnancy is a complex condition. Several aspects of management have not been evaluated. Prospective studies for improving the outcomes are needed.
INTRODUCTION: Maternal cardiac arrest is a rare condition. Cardiopulmonary resuscitation (CPR) in pregnancy is different from that in other populations due to physiological changes in patients. Extracorporeal cardiopulmonary resuscitation (ECPR) is recommended in patients having cardiac arrest with potentially reversible etiologies. However, data regarding ECPR in pregnancy are limited. CASE SUMMARY: A 24-year-old woman with a 33-week twin pregnancy developed witnessed cardiac arrest in an antenatal clinic. She underwent perimortem cesarean delivery (PMCD) and ECPR, but uterine atony with massive bleeding occurred. Emergency hysterectomy and massive blood transfusion were performed in the emergency department and the patient was transferred to the intensive care unit after hemodynamics was stable. CONCLUSION: Cardiac arrest in pregnancy is a complex condition. Several aspects of management have not been evaluated. Prospective studies for improving the outcomes are needed.