A Report of Fetal Demise During Therapeutic Hypothermia After Cardiac Arrest
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Therapeutic hypothermia is becoming the standard-of-care for coma following out-of-hospital cardiac arrest. Pregnancy has been considered a contraindication for therapeutic hypothermia.
A 44-year-old woman presented after a witnessed out-of-hospital ventricular fibrillation cardiac arrest. She remained comatose upon hospital admission and was treated with induced hypothermia via surface cooling pads. An intrauterine pregnancy of 20 weeks gestation was discovered on admission. One day after admission, a stillborn fetus was spontaneously delivered. The patient made a good neurologic recovery and now lives at home with her family.
During pregnancy, beneficence toward the pregnant woman must be the primary ethical guideline in emergent, life-threatening situations. Pregnancy should not be a contraindication to therapeutic hypothermia following cardiac arrest.
KeywordsCardiopulmonary resuscitation Sudden cardiac death Hypoxic-ischemic encephalopathy Induced hypothermia Pregnancy Stillbirth Fetal demise
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