2018, Number 2
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ABSTRACTIntroduction: 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.
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