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Resuscitative hysterotomy
A resuscitative hysterotomy (also referred to as an emergency hysterotomy, perimortem Caesarean section (PMCS) or perimortem Caesarean delivery (PMCD)) is a hysterotomy performed to resuscitate a woman in middle to late pregnancy who has entered cardiac arrest. Combined with a laparotomy, the procedure results in a Caesarean section that removes the aortocaval compression caused by the pregnant uterus, improving maternal chances of return of spontaneous circulation and potentially also delivering a viable neonate.
==Medical uses==
The procedure should be considered within around four minutes after the onset of maternal cardiac arrest if basic and advanced life support attempts are proving unsuccessful at achieving return of spontaneous circulation, and her uterus is deemed capable of causing aortocaval compression. The threshold is passed when the fundus may be palpated at the level of the umbilicus; for a singleton pregnancy, this occurs at around 20 weeks of gestational age.〔〔 Although hysterotomy is crucial for resuscitation of the mother in such situations, if the gestational age is less than approximately 24 to 25 weeks the procedure will necessarily lead to sacrifice of the fetus, as this is estimated to be the lower limit for fetal viability.〔 Where the fetus over 24 weeks, Caesarean delivery also offers the best chance of rescue as it allows neonatal resuscitation to commence.〔
If the mother's medical condition is such that there is no reasonable prospect of maternal resuscitation or viability (for example, after a nonsurvivable injury, or an unwitnessed arrest with prolonged pulselessness), then the procedure may be attempted immediately as a means of saving the unborn fetus.〔
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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