Search
Another case series of 3 resuscitative hysterotomies, all performed by obstetricians, reported 33% maternal and 67% neonate survival.(1).
The mechanics of the procedure are:
- “Duration should not exceed 5 minutes!
- Incise from pubic symphysis to at least umbilicus with a large scalpel along linea nigra into peritoneal cavity. Layers: skin, subcutaneous tissue, fascia between the rectus muscles, peritoneum.
- Retract abdominal wall laterally
- Reflect bladder inferiorly and empty by aspiration
- Make a small incision (~5cm) vertically into the inferior presenting part of the uterus until amniotic fluid comes or through endometrium
- Insert 2 fingers and lift up uterus from foetus
- Extend uterine incision up to fundus with safety scissors curved away from foetus
- Deliver the foetus. May need to disengage the presenting part from the pelvis.
- Clamp the cord twice and cut between clamps
- Give the neonate to the neonatal resuscitation team” (2)
(3)
References
- Case Series of Resuscitative Hysterotomy in Pregnant Trauma Patients Performed in the Emergency Department of a Level One Major Trauma ServiceThomas A. G. Shanahan, Jason Gabriel-Anyassor, Stefan C. Kane, Kellie Gumm, David J. Read, Elyssia Bourke Emergency Medicine AustralasiaVolume 37, Issue 3 e70078 First published: 03 June 2025 https://doi.org/10.1111/1742-6723.70078
- Perimortem Caesarean section Life in the Fast Lane. Matthew Quo and Chris Nickson May 23, 2024 https://litfl.com/perimortem-caesarean-section/
- Trauma in Pregnancy Posted on March 20, 2023 by Julissa De La Cruz https://sinaiem.org/foam/trauma-in-pregnancy/