South Bend, IN – When 33-year-old Cindy Goodling was rushed to the emergency room at Memorial Hospital of South Bend, unconscious and in cardiac arrest, therapeutic hypothermia was the best treatment available to save her.
Except that Goodling was pregnant.
Goodling, who went into cardiac arrest at a church function, was one of the 295,000 out-of-hosptial victims of cardiac arrest in the US each year. The American Heart Association states that out of the 23.8 percent of those who survive long enough to reach a hospital, only 7.6 percent are discharged alive, comments CafeMom.
And the number of pregnant women who survive and go on to have healthy babies? Well, Goodling is one of two, according to MedPage Today.
Therapeutic Hypothermia cools the body temperature, “[decreasing] not only oxygen demand, but the rate of tissue degeneration and build-up of toxins in the cells,” Dr. Raji Sundararajan, the emergency room doctor who treated Goodling told NBC Today. However, when a pregnant person’s body temperature drops, so does the temperature of the baby.
When Goodling was presented on February 13, 2009 to Sundararajan, this risky cooling procedure had only been used twice on pregnant patients; and only one of the fetuses survived. Goodling had already been shocked with a defibrillator multiple times to keep her heart beating, and Sundararajan had to make a decision. After a debate amongst the staff and “a delay of 3 hours to allow for additional imaging studies,” a decision was reached: “I believed in hypothermia. I believed it would be beneficial to her. You worry about liability, but you can’t let that guide your medical decisions,” Sundararajan states (NBC Today).
Turns out that induced hypothermia isn’t the most high-tech of medical procedures: “We take Ziploc bags of ice and throw it on the patient, basically,” explains Sundarajan. After 12 hours of sustaining a significantly lowered body temperature and an ultrasound showing Goodling’s 20-week-old fetus shivering in the womb, Goodling regained consciousness.
Nineteen weeks later, Collin was born. Three years later, they call the healthy 3 year old “Zap,” “after the defibrillator shocks it took to restart [Goodling’s] heart.”
In spite of the success of the risky cooling treatment that saved Goodling and her son, the American Heart Association still claims that it is too dangerous a treatment to use routinely on pregnant patients: “Until further data are available, therapeutic hypothermia should not be used for patients with severe cardiogenic shock or life-threatening arrhythmias, pregnant patients, or patients with primary coagulopathy.”
With such odds, is the risk worth it? Should risky medical procedures be experimented on pregnant women? Holding healthy Collin in her arms, Cindy Goodling thinks it was worth the risk.