37 - Peri-and postmortem caesarean section

Summary

This chapter discusses the key implications and action strategies for peri- and postmortem caesarean section. Perimortem caesarean section is performed under a stressful, unfamiliar situation with a collapsed mother, without any analgesia, with ongoing cardiac compressions and usually in an unfamiliar environment without recourse to appropriate equipment and support. The outcome of a resuscitation attempt in cardiac arrest depends on the underlying cause of the arrest and the effectiveness of initial resuscitation. The '4-minute rule' is the recommended approach the patient should be resuscitated in the lateral position and any treatable cause such as magnesium sulphate toxicity or poisoning should be addressed at the same time. Regular mock drills in cardiopulmonary resuscitation (CPR) should be carried out and perimortem caesarean section should be included in the training sessions. All staffs involved in perimortem caesarean section should have a de-briefing as this is a stressful and traumatic incident.