Cesarean delivery of twins during maternal cardiopulmonary arrest

Background: In modern times, maternal death is rare. Timely cesarean delivery in the setting of maternal cardiopulmonary arrest may save both the infant and the mother. Case: A 36-year-old white woman with a twin pregnancy suffered cardiopulmonary arrest at 28 weeks' gestation. Advanced cardiopulmonary resuscitative measures were unsuccessful, and the twins were delivered by cesarean at the bedside. Immediately after delivery, a maternal pulse was noted; both the mother and her infants are alive 15 months later. Conclusion: Relieving vena caval occlusion by perimortem cesarean delivery in a term gravida allows chest compressions to provide sufficient cardiac output in the unfortunate event of maternal cardiopulmonary arrest. When delivery occurs within 5 minutes of maternal insult, the neonatal outcome is favorable. (Obstet Gynecol 1998;92:695-7. (C) 1998 by The American College of Obstetricians and Gynecologists.).