Ozkan Onal, Eyup Aydogan, Ates Duman and Jale Bengi Celik
Accepted Abstracts: Surgery Curr Res
Introduction: Sudden cardiac arrest is the most common cause of cardiac deaths in all developed countries and is usually idiopathic. However, in pregnant women cardiac arrest may occur owing to events and alterations developing during birth. Aim: The aim of this case report is to present a case of infertile patient whose pregnancy remained unknown and had cardiac arrest in order to stress the need for pregnancy investigation for every patient in fertile ages. Case: A 32 year old patient was admitted to our ICU (intensive care unit) in intubated condition and with closed consciousness after cardiac arrest and resuscitation. No cause for respiratory arrest could be found in her history. Her pregnancy status was questioned and it was learned that she underwent fertility treatment for the last five years. When pregnancy suspicion was aroused upon beta HCG analysis, obstretric clinics was consulted. In ultrasonography (USG) analysis, pregnancy sac could not be detected and repetition of laboratory investigations was recommended. 1 week later, beta HCG level increased significantly and embryo sac was detected in USG. During treatment in ICU, probable effects on the fetus was taken into account as much as possible. Meanwhile, she was followed for 69 days in ICU and treacheostomy was closed before being transferred to obtretrics clinic in walking and talking condition with an intact fetus. Then, patients and her relatives were informed by obstretrics and intensive care unit physicians on resuscitation procedure and the probable side effects of the drugs she received in ICU on fetus. In addition, radiologists calculated the amount of radiation received during treatment and its probable side effects on the fetus were explained. In view of this information, patient and her relatives decided to continue pregnancy. At present, fetus is 28 weeks old and in USG evaluations, no anomaly except for intrauterine growth retardation was found. Discussion: There are various causes of cardiac arrest in pregnant women. Mortality associated with pregnancy itself is rare and occurs once every 30.000 pregnancies. Lung embolism is thought to be the most common medical cause of death in pregnant women. However, in the present case, no cause that can explain arrest could be found. Conclusion: All women at fertile ages admitted to hospital should undergo pregnancy examination. If an unexpected cardiovascular event takes place in the pregnant woman, child should always be kept in consideration during treatment. This will both protect the physician from probable legal problems and make it possible to arrange treatment in a way that will harm the fetus least.
Ozkan Onal has completed his medical education at Gazi University Medical Faculty and he was specialized in anesthesiology in Hacettepe University Medical Faculty. He has more than 15 publications in reputed journals in the field of anesthesia.
