Embryo Project Encyclopedia Articles

In 1986, Vern L. Katz, Deborah J. Dotters, and William Droegemueller published “Perimortem Cesarean Delivery,” an article in which they developed the Four Minute Rule for perimortem cesarean sections. The Four Minute Rule states that if a pregnant woman’s heart stops beating, physicians should begin an operation to deliver the fetus within four minutes and aim to have the fetus delivered within five minutes of cardiac arrest. Although cardiac arrest during pregnancy is uncommon, it can happen when pregnant women experience trauma, blood clots, infection, or have preexisting heart conditions. In the article, the authors emphasize how the Four Minute Rule increased maternal and fetal survival rates and decreased cases of severe fetal brain damage. The article “Perimortem Cesarean Delivery” was the first article to present the Four Minute Rule, which has influenced international guidelines and become the standard for maternal resuscitation and fetal survival in emergency medicine, operating rooms, and many other aspects of medical practice.

In 1980 the US National Institutes of Health (NIH) and the US National Institute of Child Health and Human Development (NICHD) released a report titled, “National Institutes of Health Consensus Development Conference Statement September 22–24, 1980.” The report lists recommendations for birth delivery through cesarean sections, a surgical procedure used to deliver the fetus via the pregnant woman’s abdomen. The recommendations arose from the 1980 Consensus Development Conference on Cesarean Childbirth in Bethesda, Maryland. Medical professionals, consumers, and biomedical research scientists attended the conference, and the NIH’s taskforce on the subject helped facilitate discussions regarding the safety of cesarean sections. The NIH taskforce concluded that cesarean section rates can be decreased and possibly reversed in addition to improving maternal and fetal outcomes and provided recommendations for future research on cesarean sections.