11^th Global Healthcare and Fitness Summit

According to the present guidelines, an emergency hysterotomy should be performed after four minutes of maternal cardiac arrest, if no signs of life are detected. The meaning of this extreme procedure is to benefit both the mother and the infant. The key factors associated to both maternal and neonatal survivals seem to be the time delay between the cardiac arrest and the delivery, and in-hospital location during an arrest situation. Furthermore, better neonatal outcomes are believed to depend on a higher gestational age. We report two emergency hysterotomies executed in out-of-hospital location. In both cases, very unfortunately the mothers perished after the operation, but amazingly both infants survived. Against to the earlier beliefs of factors associating to survival, these were low birth weight infants, and born by an emergency hysterotomy 20-23 minutes after maternal cardiac arrest. At the age of two years, both infants had normal physical and neurological growth. With our patient

cases, we wish to encourage other prehospital physician units to train and prepare for emergency hysterotomy. Although considered desperate and extremely rare, a successful emergency hysterotomy is possible also in prehospital setting.