Anesth Pain Med.  2016 Jul;11(3):269-272. 10.17085/apm.2016.11.3.269.

Cardiac arrest in a pregnant woman with pregnancy-induced hypertension: A case report

• Yoon HJ
• Kim YD
• Jee YS

• KMID: 2344930
• DOI: http://doi.org/10.17085/apm.2016.11.3.269

Abstract

A 39-year-old woman with an intrauterine pregnancy and small-for-gestational-age fetus was admitted at 34 + 1 weeks for management of pregnancy-induced hypertension. On the 13th day of admission, the patient was found in the ward toilet with a cardiac arrest. Cardiopulmonary resuscitation (CPR) was initiated immediately and cardiac monitoring revealed asystole. Manual uterine displacement was performed for CPR to be effective. A return of spontaneous circulation was observed, but repeated cardiac arrest occurred subsequently. Twenty-one minutes after starting CPR, a peri-mortem cesarean section was started, and delivery occurred 1 minute later. After delivery of the fetus, the patients' blood pressure stabilized, but there was no spontaneous respiration. Emergency brain CT revealed a large subarachnoid hemorrhage. Neonatal brain ultrasound showed hypoxic-ischemic encephalopathy. The patient was transferred to another hospital for neurosurgical intervention, where she expired on the third day after cardiac arrest.

Keyword

Cardiac arrest; Cardiopulmonary resuscitation; Perimortem cesarean section; Pregnancy

MeSH Terms

Adult
Blood Pressure
Brain
Cardiopulmonary Resuscitation
Cesarean Section
Emergencies
Female
Fetus
Heart Arrest*
Humans
Hypertension, Pregnancy-Induced*
Hypoxia-Ischemia, Brain
Pregnancy
Pregnant Women*
Respiration
Subarachnoid Hemorrhage
Ultrasonography

Figure

• 

  Fig. 1 The emergency brain CT scan showed large amount of subarachnoid hemorrhage in bilateral basal cistern (white arrow), sylvian (arrowhead) and inter-hemispheric fissures (black arrow).

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