Ulus Travma Acil Cerrahi Derg. 2023; 29(3): 440-442 | DOI: 10.14744/tjtes.2022.34124

Travmaya baðlý gecikmiþ postmortem sezaryen

Gizem Oncel Yel¹, Aykut Kemanci², Atakan Yýlmaz³, Özmert M.A. Özdemir⁴, Bulent Erdur^3
1Denizli Servergazi Devlet Hastanesi, Acil Týp Kliniði, Denizli
²Doç. Dr. Mustafa Kalemli Tavþanlý Devlet Hastanesi, Acil Týp Kliniði, Kütahya
³Pamukkale Üniversitesi Týp Fakültesi, Acil Týp Anabilim Dalý, Denizli
⁴Pamukkale Üniversitesi Týp Fakültesi, Pediatri Anabilim Dalý, Neonatoloji Bilim Dalý, Denizli

Kardiyopulmoner arrest hamilelik sýrasýnda nadir görülen bir durumdur. Gebeliðinin ikinci yarýsýnda annenin arrest olduðu fark edilir edilmez, týbbi ekipler perimortem sezaryen (C/S) için çaðrýlmalýdýr. Olgumuzda 31 haftalýk gebe hasta trafik kazasý sonrasý acil servise (AS) 112 ekibi tarafýndan kardiyopulmoner resüsitasyon (KPR) eþliði ile getirildi. Nabzý olmayan veya spontan solunumu olmayan hasta eksitus olarak kabul edildi. Bununla birlikte, CPR fetüsün saðkalýmýný korumak için sürdürüldü. Nöbetçi kadýn doðum doktoru gelmeden önce, acil servis hekimleri olarak fetusun fetal mortalite ve morbidite riskinin artmasýný önlemek için C/S’yi baþlattýk. 1/5/10 dakikada Apgar skorlarý 0/3/4 ve oksijen satürasyon deðerleri sýrasýyla %35/65/75 idi. Postnatal 11. günde ileri kardiyak yaþam desteðine raðmen yanýt vermeyen hasta exitus olarak kabul edildi. Acil servis ekibi, C/S ve yenidoðan ve bakýmý konusunda bilgili ve donanýmlý olmalýdýr. Bizim olgumuzda ise annenin tahmini saatine göre fetüsun anne rahminden çýkarýlmasý 40 dakika sürmüþtür.

Anahtar Kelimeler: Acil servis, gebe arrest, postmortem sezaryen; travma.

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Delayed postmortem cesarean section due to trauma

Gizem Oncel Yel¹, Aykut Kemanci², Atakan Yýlmaz³, Özmert M.A. Özdemir⁴, Bulent Erdur^3
1Department of Emergency Medicine, Servergazi State Hospital, Denizli-Türkiye
²Department of Emergency Medicine, Doç. Dr. Mustafa Kalemli Tavþanlý State Hospital, Kütahya-Türkiye
³Department of Emergency Medicine, Pamukkale University Faculty of Medicine, Denizli-Türkiye
⁴Department of Pediatrics, Division of Neonatology, Pamukkale University Faculty of Medicine, Denizli-Türkiye

Cardiopulmonary arrest is an occasional occurrence during pregnancy. As soon as maternal arrest is noticed in a woman in the second half of her pregnancy, medical teams should be called for perimortem cesarean (C/S). A 31–week-pregnant female patient was brought to our emergency department by the emergency medical service team with cardiopulmonary resuscitation (CPR) after a traffic accident. The patient, with no pulse or spontaneous breathing, was recognized as exitus. However, CPR was sustained to maintain fetal well-being. Before the arrival of the on-call gynecologist, we as emergency physicians initiated C/S both for fetal well-being and to avoid heighten-ing the risk of fetal mortality and morbidity. The Apgar scores were 0/3/4 and oxygen saturation values were 35/65/75% at 1/5/10 min, respectively. On the postnatal 11th day, the patient did not respond despite the advanced cardiac life support (ACLS) and thus was con-sidered exitus. The ACLS team should be knowledgeable and well-equipped to perform C/S, to do aftercare, to watch for related risks in the infant. In our case, it took 40 min for the fetus to be removed from the mother’s womb, starting from the estimated time of exitus.

Keywords: Emergency department, postmortem cesarean, pregnancy arrest; trauma.

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