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
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)
where:
• Fetal survival is possible at around 24 weeks gestation.
