Resuscitative Hysterotomy - Procedure Instructions
When? ...
37
Description

Resuscitative Hysterotomy - Procedure Instructions
When? ASAP. Within 4 minutes when possible.
Who? Pregnant patient with uterus above umbilicus.
Why? To increase chance of maternal survival.
1) Cardiac Arrest Management
 • Call for help: ICU, 0B
 • Compressions, Airway, Defib early
 • Use hands to cup uterus up and to left
 • IV above diaphragm
2) Gather Supplies
 • Chlorhexidine, Sterile gloves & towels.
 • Scalpel, Scissors
 • Umbilical Clamps
3) Cut Abdomen
 • Scalpel: Midline Incision Umbilicus - Pubic symphysis
 • Fingers: Bluntly separate rectus muscles down middle
 • Scissors or Fingers: Bluntly open peritoneum
4) Cut Uterus
 • Scalpel: Small incision lower end of uterus
 • Insert Fingers, lift uterus wall away from infant
 • Scissors: Cut uterus to fundus
5) Deliver
 • Push head out, then body. Apply fundal pressure PRN.
 • Clamp & cut cord → NRP.
 • Deliver placenta.
6) Continue Maternal Care
 • Compressions + Consider Reversible
 • If ROSC: prepare to manage PPH, temporarily pack abdomen.

Dr. Sarah Foohey @SarahFoohey

#Resuscitative #Hysterotomy #Procedure #Instructions #checklist #obstetrics #emergency
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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