The case of a severely traumatized pregnant patient, in whom a perimortem cesarean section, in the emergency department, led to the birth of a viable baby, with long-term survivor, is described. A postmortem cesarean section, resulting in fetal survival, performed after 45 minutes of maternal cardiopulmonary resuscitation is reported in a patient with multiple penetrating injuries. A 27-year-old primigravida suffered cardiopulmonary arrest at the 34th week of gestation following multiple knife injuries. Although extensive advanced cardiopulmonary resuscitation was performed for 45 minutes, her vital signs did not return to normal levels. A low segment cesarean delivery was performed, and a female baby was delivered. The time interval between cardiopulmonary arrest and delivery, prior maternal health status, and continued cardiopulmonary resuscitation are important determinants of fetal survival. A perimortem cesarean section is advised in case of multiple penetrating injuries, even after 45 minutes of cardiopulmonary resuscitation, since it may result in fetal salvage.
Adult ; *Cardiopulmonary Resuscitation ; *Cesarean Section ; Fatal Outcome ; Female ; Heart Arrest ; Human ; Infant, Newborn ; Pregnancy ; *Pregnancy Complications ; Pregnancy Outcome ; Wounds, Stab/*complications

BACKGROUND:Carbon monoxide poisoning (COP) is an important cause of mortality and morbidity worldwide. This study was to investigate the levels of serum paraoxonase (PON), arylesterase (ARYL), ceruloplasmin (Cp), and sulfhydryl (-SH) in the treatment of COP, and to further understand the pathophysiology of COP. METHODS:This prospective study comprised 107 individuals with COP (group 1) and 50 healthy volunteers (group 2). Serum, plasma, and erythrocyte samples were taken on admission from allparticipants with COP. This process was repeated in the 90th and 180th minutes of treatment. Samples were taken from the control group only once. The levels of plasma PON, ARYL, Cp activity and -SH were measured in both groups. RESULTS:Age, gender, and carboxyhemoglobin level were not correlated with PON, ARYL, Cp, and -SH levels. PON, ARYL, and -SH levels were significantly decreased in group 1 compared with group 2. Conversely, Cp was significantly elevated in group 1 in contrast to group 2. Although ARYL was lower on admission in patients with COP than that was observed in the 90th and 180th minutes (P<0.001), Cp was higher on admission than at the other time points (P<0.001). CONCLUSIONS:Participants with COP had decreased levels of antioxidants (PON, ARLY, and -SH). COP represses the antioxidant system.