cardiac arrest in pregnancy

Question 1

3 major causes of cardiac arrest in pregnancy

Answer 1

obstetric haemorrhage
PE
sepsis –> metabolic acidosis and shock

Question 2

causes of obstetric haemorrhage

Answer 2

ectopic pregnancy 
placental abruption 
placenta praevia
placenta accreta
uterine rupture

Question 3

Aortocaval Compression

Answer 3

when pregnant woman is supine the mass of the uterus can compress IVC and aorta

–> reduced venous return –> reduced cardiac output –> hypotension

Question 4

Aortocaval Compression

- solution

Answer 4

place woman in the left lateral position

–> lying on her left side with pregnant uterus positioned away from IVC

Question 5

principles

Answer 5

• 15degree tilt to left side
• early intubation to protect airway
• early supplementary oxygen
• aggressive fluid resuscitation
• delivery of baby after 4mins and within 5mins CPR

Question 6

when is immediate CS performed

Answer 6

• no response after 4mins CPR

- CPR continues for more than 4mins in woman >20wks