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.

Roberto Caldeyro-Barcia studied fetal health in Uruguay during the second half of the twentieth century. Caldeyro-Barcia developed Montevideo units, which are used to quantify intrauterine pressure, or the force of contractions during labor. Intrauterine pressure is a useful measure of the progression of labor and the health of a fetus. Caldeyro-Barcia’s research on fetal health often contradicted common obstetric practices, prompting him to publically challenge practices such as induction of labor using oxytocin, forced pushing during labor, and birth position in which the woman lays on her back during labor. Caldeyro-Barcia’s methods of monitoring intrauterine pressure and development of Montevideo units furthered research in maternal and fetal health and improved the use of medical interventions during labor and delivery.