임산부의 심폐소생술 중 시행한 응급제왕절개술 1례 = A Case that Pregnant Woman was Performed Emergency Cesarian Section During CPR

다국어 초록 (Multilingual Abstract)

Cardiac arrest during pregnancy is an uncommon event,
occurring only about once in every 30,000 late pregnancies.
Survival from such an event is exceptional. This case
involves sudden cardiac arrest of a 32 weeks pregnant
woman. The patient was found at unresponsive state and
transferred to emergency center by EMS. At arrival, her
EKG rhythm was asystole and we had no patient information.
Upon initiation of ACLS, abdominal ultrasonography
was done and we detected a fetal heart beat. Timely emergency
caesarean section delivery was done and the 1-
minute APGAR score of neonate is 0. After endotracheal
intubation and respiratory assist, 3-minute APGAR score
was recoverd to 3 and neonate was admitted to neonate
ICU. The mother did not responsed to resuscitation efforts.
Physiologic and anatomic changes occur during normal
pregnancy, necessitating a modification of standard BLS
and ACLS methods for successful resuscitation. When
arrest does occur during the latter part of pregnancy, perimortem
caesarean delivery may improve the outcome for
both the fetus and the pregnant woman.

국문 초록 (Abstract)

임신부의 심폐소생술에 있어서 빠른 기관삽관,산소 공급, 대동정맥 압박의 방지를 위한 위치 변화 등 임산부의 생리적 변화에 맞는 심폐소생술의 방법을 사용해야한다. 임신 20주 이후의 심정지의 경우 심정지 5분 이내의빠른 응급제왕절개술이 산모와 태아의 생존에 중요하며 임신주수, 심정지의 원인, 제왕절개술의 기술적 능력을 판단하여 시행여부를 판단해야 한다. 본 저자들은 흔하지 않은임신부의 심정지에서 심폐소생술 중 응급제왕절개술을 통한분만을 경험하였기에 보고하는 바이다.

참고문헌 (Reference)

1 "Working group on CPR of the european academy ofanaesthesiology" 437-40, eurjanaesthesiol1993;10

2 "Resuscitation in pregnancy" 327 : 1277-1279, 2003

3 "Perimortem cesarean delivery: were our assumptions correct?" 192 : 1916-1920, 2005

4 "Maternal cardiac arrest in pregnancy" 45 : 377-392, 2002

5 "European resuscitation council guide-lines for resuscitastion 2005" 67 : 135-170, 2005

6 "Complete maternal and fetal recov-ery after prolonged cardiac arrest" 346-9,

7 "Cardiac arrest during pregnancy" 17 : 229-234, 2005

8 "2005 American heart associa-tion guidelines for cardiopulmonary resuscitation andemergency cardiovascular care"