Maternal Collapse Flashcards
causes of maternal collapse
- HEAD= eclampsia, epilepsy, cerebrovascular accident, vasovagal response
- HEART= MI, arrhythmias, peripartum cardiomyopathy
- HYPOXIA= asthma, PE, pulmonary oedema, anaphylaxis
- HAEMORRHAGE= abruption, atony, trauma, uterine rupture, uterine inversion, aneurysm
- wHole body and HAZARDS= hypoglycaemia, amniotic fluid embolism, septicaemia, trauma, anaesthetic complications, drug overdose, etc.
reversible causes of cardiac arrest
4 T’s
4H’s
2C’s = eclampsia and intracerebral bleed
management of collapse
resuscitation
perimortem C/S
drugs
complications of resuscitation in pregnancy
needs uterine displacement or left lateral lie as uterus compresses IVC and aorta
aspiration more common due to progesterone
what is a perimortem C/S
no response to CPR in 4 minutes then perform C/S
specific drug treatments
cardiac arrest 1mg adrenaline every 2 mins, VF/VT 300mg amiodarone, opiate overdose 0.4-0.8mg naloxone, magnesium toxicity 1g calcium gluconate and local anaesthetic toxicity 1.5ml 20% intralipid
what is an amniotic fluid embolism?
usually happens in labour where the amniotic fluid enters the maternal circulation
presentation of amniotic fluid embolism
anaphylactic reaction to amniotic fluid causes pulmonary hypertension and hypoxia
management of amniotic fluid embolism
delivery
support
what is cord prolapse
cord leaves before the baby and can be compressed
management of cord prolapse
immediate forceps
C/S
grades of C/S
1-5
what is cord presentation?
cord presents at cervical os
puerperal sepsis antibiotics of choice
co-amox +met +/- gent
fluids
