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Cesarean Section, Emergency

Cesarean Section, Emergency is a topic covered in the 5-Minute Emergency Consult.

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Basics

ALERT
  • The sole indication for ED physician to perform emergency perimortem cesarean section is a gravid female (>24 wk gestation) in cardiopulmonary arrest who has not responded to initial resuscitative measures, regardless of cause
  • The most important predictor of fetal survival is length of time between maternal cardiac arrest and cesarean delivery:
    • Cesarean section should begin within 4 min of maternal arrest
    • Goal is delivering fetus within 1 min
  • Obtain immediate consultations from obstetrics, pediatrics (and surgery, if trauma related):
    • Do not defer or delay performing procedure until arrival of consultants
  • Do not perform emergent cesarean section if patient is <24 wk gestation

Etiology

  • Trauma (penetrating or blunt):
    • Major cause of maternal mortality
  • Pulmonary embolus:
    • Thromboembolism is most common cause of nontraumatic maternal mortality
  • Cerebral vascular accident
  • Amniotic fluid embolism
  • DIC
  • Placenta previa
  • Eclampsia
  • Miscellaneous medical disorders:
    • Asthma
    • CHF
    • MI
    • Drug overdose

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Citation

Rosen, Peter, et al., editors. "Cesarean Section, Emergency." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307371/all/Cesarean_Section__Emergency.
Cesarean Section, Emergency. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307371/all/Cesarean_Section__Emergency. Accessed April 26, 2019.
Cesarean Section, Emergency. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307371/all/Cesarean_Section__Emergency
Cesarean Section, Emergency [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307371/all/Cesarean_Section__Emergency.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Cesarean Section, Emergency ID - 307371 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307371/all/Cesarean_Section__Emergency PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -