• Xrj Moors, T H Biesheuvel, J Cornette, M G Van Vledder, A Veen, M de Quelerij, Eem Weelink, and J J Duvekot.
• Department of Anaesthesiology, Erasmus MC, University Medical Center Rotterdam-Sophia Children's Hospital, Rotterdam, The Netherlands; HEMS, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: x.moors@erasmusmc.nl.
• Resuscitation. 2020 Oct 1; 155: 112-118.

BackgroundPrehospital perimortem caesarean delivery (PCD) is a rarely performed procedure. In this study, we aimed to examine all PCDs performed by the four Helicopter Emergency Medical Services in the Netherlands; to describe the procedures, outcomes, complications, and compliance with the recommended guidelines; and to formulate recommendations.MethodsWe performed a population-based retrospective cohort study of all consecutive maternal out-of-hospital cardiac arrests that underwent PCD in the prehospital setting between May 1995 and December 2019. Registered data included patient demographics, operator background, advanced life support interventions, and timelines. Resuscitation performance was evaluated according to the 2015 European Resuscitation Guidelines.ResultsSeven patients underwent a prehospital PCD. Three mothers died on the scene, while four were transported to a hospital but died in the hospital. Seven neonates were born by PCD. One neonate died on the scene and six were transported to a hospital. Three neonates were eventually discharged from the hospital. Among the three surviving neonates, the periods from dispatch to start of PCD were 13, 14, and 21 min.ConclusionsThere was a low incidence of maternal perimortem caesarean deliveries in The Netherlands. Only some neonates survived after PCD. It is recommended that PCD be performed as quickly as possible. Due to the delay, the mother has a far lower chance of survival than the neonate. In fatal cases, autopsy is strongly recommended.Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.

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