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>Journals >Revista de la Facultad de Medicina UNAM >Year 2018, Issue 2

Meza FE, Betancourt VM, Moncada ME, Flores HV, Vázquez MJC
Perimortem C-section after trauma due to a gunshot with the survival of the infant A case report
Rev Fac Med UNAM 2018; 61 (2)

Language: Español
References: 16
Page: 24-28
PDF: 172.23 Kb.

Full text


Introduction: Trauma in pregnancy is a complex scenario. Very few publications study the secondary issues of trauma in the third trimester, including the indications and outcomes of an emergency C-Section. A perimorten Cesarean Section is an unusual event and when it is performed it usually is the only resource for the survival of the infant. When there is cardiac arrest, perimortem Cesarean Section is indicated 4 to 5 minutes after cardiac arrest.
Case: A 19-year-old female, with a recent history of a gunshot injury in the chest, arrives in cardiac arrest, CPR was performed and has a 36 week pregnancy. 4 cycles of cardiopulmonary resuscitation where performed without reversion to spontaneous circulation. Hence, it was decided that a general surgeon would perform a perimortem Cesarean Section in the trauma room. A living infant was obtained; and the death of the mother was reported minutes later. The infant was transferred to the NICU. Five days after the procedure, the reports did not show neurological sequelae.
Conclusion: The first reason to perform a perimortem Cesarean Section was the survival of the mother, and because it was an emergency, it was not necessary to waste time in verifying the infant’s vitals. Yet, in special cases, where there are very few possibilities of the survival of the mother, the perimortem cesarean section should be performed for infant survival.
Performing this procedure requires quick decision-making skills. It’s very important to remark that this procedure was performed in a Trauma Center, which has the facilities of a trauma room, where one can do emergency procedures faster and with a trained medical staff. There was no need to move to an operating room to perform it, resulting in a successful outcome.

Key words: Perimortem C Section, Infant Survival, trauma.


  1. Morris JA, Rosenbower TJ, Jurkovich GJ, Hoyt DB, Harviel JD, Knudson MM, et al. Infant survival after Cesarean Section for Truma. Ann of Surg. 1999;223:481-91.

  2. Azpilcueta AJ, Martinez CC, Hernandez SR, Martinez EM. Operación Cesárea postmortem con supervivencia fetal. Informe de un caso. Rev Med del Hosp Gen Mex, SS. 1999;62:132-4.

  3. American College Of Surgeons. Advanced Trauma Life Support. ATLS, 9th Edition. 2012, pp. 293-4.

  4. Katz VL, Dotters DJ, Droegmeuller W. Perimortem cesarean delivery. Obstet Gynecol. 1986;68:571-6.

  5. El Kady D. Perinatal Outcomes of traumatic injuries during pregnancy. Clin Obstet Gynecol. 2007;50:582-91.

  6. Lang CT, King JC. Maternal mortality in the United States. Best Pract Res Clin Obstet Gynecol. 2008;22:517-31.

  7. Kuczkauski KM. Trauma during pregnancy, a situation with danger. Acta Anaesth Belg. 2005;56:13-8.

  8. Ernest E. Moore; Kennet L. Mattox; David V. Feliciano. Trauma. 7 Ed., Houston, TX: Mc Graw Hill, 2013.

  9. Whitten M, Montgomery L. Postmortem and perimortem cesarean section: what are the indications? J R Soc Med. 2000;93:6-9.

  10. Dewhurst CJ. e Ruptured cesarean section scar. J Obstet Gynaecol Br Emp. 1957;69:113-8.

  11. Malloy BG, Shiel D, Duignon NM. Delivery after cesarean section, a review of 2 176 consecutive cases. BMJ. 1987;294:1645-7.

  12. Phileon JP. Clark SL, Diaz F, Paul RH. Vaginal birth after cesarean. Am J Obstet Gynael. 1987;157:1510-5.

  13. Gallup DG. Surgical Incisions. En: Phelon JP, Clark SL (eds). Cesarean Delivery. New York: Elsevier Science; 1988. p. 217.

  14. Kue R, Coyle C, Vaughan E. Perimortem Cesarean section in the helicopter EMS setting: A case report. Air Medical Journal. 2008;27:46-7.

  15. Bowers W, Wagner C. Field Perimortem Cesarean section. Air Medical Journal. 2001;20:10-1.

  16. Urrego LA, Cardenas DP, Velazquez JF, et al. Cesárea perimortem y reanimación materno fetal en el Servicio de Urgencias: Reporte de un caso y revisión de la literatura. Revista de la Asoc Mex Med Crit y Ter Int. 2012;26:247-50.

>Journals >Revista de la Facultad de Medicina UNAM >Year 2018, Issue 2

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