ABSTRACT
Cardiopulmonary arrest in pregnancy is a rare emergency which occurs in approximately 1/12,000 admissions for delivery. A perimortem cesarean delivery (PMCD) is one which occurs after the initiation of cardiopulmonary resuscitation (CPR). Guidelines for the management of the pregnant patient after cardiac arrest are largely based on expert opinion and case series without the benefit of randomized controlled trials. The most common obstetric causes of cardiopulmonary arrest in pregnancy are hemorrhage, hypertensive disorders of pregnancy, idiopathic peripartum cardiomyopathy, anesthetic complications, and amniotic fluid embolism. There is a direct relationship between the timing of delivery and the survival of both the mother and the neonate. A review of 38 cases of PMCD between 1998 and 2004 showed the survival of 34 infants and 13/20 mothers with reversible causes of arrest. PMCD is a rare event which, when performed in a timely manner, may lead to improved maternal outcome and fetal survival.
