Our Summary

This research paper is about a simple method for performing an emergency C-section during a life-threatening situation (like a cardiac arrest) in pregnant women who are at least 20 weeks along. It provides guidelines for when this procedure should or should not be done, why it can be beneficial, what equipment is needed, and how to actually carry out the procedure. The paper also looks at recent studies on how successful these emergency C-sections are for both the mother and baby. The authors emphasize the importance of doctors practicing and preparing for this kind of C-section so they can perform it effectively in an emergency to maximize the survival chances of both the mother and baby.

FAQs

  1. What is a perimortem cesarean section (PMCS)?
  2. What are the indications and contraindications for a perimortem cesarean section?
  3. What equipment is needed for a perimortem cesarean section and what does the procedure entail?

Doctor’s Tip

A doctor might tell a patient that a cesarean section may be necessary if there are complications during labor and delivery that could pose a risk to the mother or baby’s health. It is important to discuss the potential risks and benefits of a cesarean section with your healthcare provider to make an informed decision about your delivery plan.

Suitable For

Patients who are typically recommended for a cesarean section include:

  1. Patients with a previous cesarean section who are at risk for uterine rupture during a vaginal delivery.
  2. Patients with placenta previa, where the placenta partially or completely covers the cervix, making vaginal delivery risky.
  3. Patients with placental abruption, where the placenta separates from the uterine wall before delivery, causing potential harm to the mother and baby.
  4. Patients with certain medical conditions that make vaginal delivery risky, such as active herpes infection, HIV, or severe cardiac disease.
  5. Patients with multiple gestations, such as twins or triplets, where a cesarean section may be safer for both the mother and babies.
  6. Patients with certain fetal conditions, such as breech presentation or macrosomia (large baby), where a cesarean section may be recommended to reduce the risk of complications during delivery.

Timeline

  • Patient is admitted to hospital for delivery either through planned cesarean section or emergency cesarean section
  • Patient undergoes pre-operative preparation including blood tests, IV fluids, and anesthesia consultation
  • Patient is taken to operating room and anesthesia is administered
  • Surgeon performs cesarean section, delivering the baby
  • Patient is monitored closely for post-operative complications such as infection, bleeding, and blood clots
  • Patient is encouraged to breastfeed and bond with baby
  • Patient is discharged from hospital with instructions for post-operative care and follow-up appointments
  • Patient may experience physical and emotional recovery in the weeks following the procedure

What to Ask Your Doctor

  1. What are the reasons for needing a cesarean section in my situation?
  2. What are the potential risks and complications associated with a cesarean section?
  3. How will the procedure be performed and what can I expect during and after the surgery?
  4. How will my recovery process be different compared to a vaginal delivery?
  5. How will a cesarean section affect future pregnancies or deliveries?
  6. What are the options for pain management during and after the surgery?
  7. Will I be able to have skin-to-skin contact with my baby immediately after the cesarean section?
  8. What are the guidelines for breastfeeding after a cesarean section?
  9. How soon after the surgery can I start moving around and caring for my baby?
  10. Are there any specific precautions or instructions I should follow post-surgery to aid in my recovery process?

Reference

Authors: Parry R, Asmussen T, Smith JE. Journal: Emerg Med J. 2016 Mar;33(3):224-9. doi: 10.1136/emermed-2014-204466. Epub 2015 Feb 24. PMID: 25714106