Parry et al identified indications and contraindications for performing a perimortem cesarean section (PMCS). The authors are from Derriford Hospital and the Royal Centre for Defence Medicine in England.

Patient selection: pregnant woman with cardiac arrest


Criteria for perimortem cesarean section - all of the following:

(1) gestational age > 20 weeks (uterine fundus palpable at or above the umbilicus for a singleton pregnancy)

(2) attempts at maternal resuscitation in the 4 minutes since maternal cardiac arrest have failed OR mother has unsurvivable condition

(3) interval since cardiac arrest 4 to 15 minutes

(4) no contraindications



(1) less than 4 minutes since maternal cardiac arrest

(2) return of spontaneous circulation (ROSC) after resuscitation attempt

(3) gestation known to be less than 20 weeks

(4) prolonged time interval since arrest (> 30 minutes absolute, > 15 minutes relative)



• Fetal survival is possible at around 24 weeks gestation.

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