Obstetric

Question 1

How is a resuscitative hysterotomy performed?

Answer 1

Indication
- >20 weeks or fundal height at or above umbilicus
- within 15mins of arrest (preferably <4 minutes)

Procedure
- Continue CPR and prepare for neonatal resuscitation
- Assemble teams ideally ACLS, hysterotomy and neontatal
- Liberal antiseptic to abdomen
- Vertical incision from umbilicus (or xiphisternum, depending on size) to the symphysis pubis)
- Separate rectus muscles then breach peritoneum with scalpel
- Identify/deliver uterus and make midline vertical incision on the anterior uterine wall
- Deliver baby, clamp and cut cord
- Deliver all of placenta and pack uterus