Case Report

Successful outcome utilizing hypothermia after cardiac arrest in pregnancy: A case report

Rittenberger, Jon C. MD, MS; Kelly, Elizabeth MD; Jang, David MD; Greer, Kenneth MD; Heffner, Alan MD

Author Information

From the University of Pittsburgh Department of Emergency Medicine (JCR) and Affiliated Residency in Emergency Medicine, Pittsburgh, PA (EK, DJ); Mercy Hospital of Pittsburgh, Pittsburgh, PA (KG, AH); Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA (AH); and Departments of Internal Medicine and Emergency Medicine, Carolinas Medical Center, Charlotte, NC (AH).

The authors have not disclosed any potential conflicts of interest.

Supported, in part, by grant 1 KL2 RR024154-02 from the National Center for Research Resources, National Institutes of Health (NIH), and NIH Roadmap for Medical Research (Dr. Rittenberger); an unrestricted grant from the National Association of Emergency Medical Services Physicians/Zoll Emergency Medical Services Resuscitation Research Fellowship (Dr. Rittenberger); and grant 5 T32 HL007820-09 from the National Institutes of Health (Dr. Heffner).

For information regarding this article, E-mail: [email protected]

Critical Care Medicine 36(4):p 1354-1356, April 2008. | DOI: 10.1097/CCM.0b013e318169ee99

Abstract

Background:

To date, pregnancy has been considered a contraindication to the use of therapeutic hypothermia after cardiac arrest.

Case:

We present the case of a 35-yr-old woman, 13 wks pregnant, who had a witnessed out-of-hospital ventricular fibrillation cardiac arrest. She was resuscitated by prehospital personnel yet remained comatose at arrival to the hospital. Therapeutic cooling (33°C) was initiated for 24 hrs, and she was discharged home with mild neurologic deficit (Cerebral Performance Category 2) on hospital day 6. The infant was delivered via cesarean section at 39 wks’ gestation. Apgar scores were 8 and 9, and neurodevelopmental testing was appropriate for age at birth and at 2 months.

Conclusion:

This is the first case of therapeutic hypothermia applied to postarrest care of a pregnant woman followed by a successful delivery. This therapy should be considered in pregnant patients with cardiac arrest.