Maternal collapse Flashcards
A 30-year-old G2P2 has just delivered her second baby and she appears well. 20 minutes after delivery you notice she has become acutely hypotensive and has marked respiratory distress. How would you assess and manage this patient?
Impression
Given the acute hypotensive state with respiratory distress I am concerned about maternal collapse.
Maternal collapse is a rare but life-threatening obstetric emergency and can occur any time during pregnancy, parturition and up to 6-weeks postpartum> the outcome depends on prom and effective resuscitation.
In this situation, a number of causes to consider;
- PPH (Tone, tissue, trauma, thrombosis) given recent parturition
- syncope, hae
Is defined as an acute event involving the cardiorespiratory systems and or CNS - leading to LOC.
Goals
- Call for help and begin immediate resuscitative measures to stabilise the patient
- consider a broad range of potential causes for the presentation
Maternal collapse - Assessment
Assessment
- call MERT, get senior help
- begin resuscitation taking A to E approach
A - patent, maintaining, adjuncts pending GCS
B - RR, SP02, supplemental as required
C - IVC access, HR/BP monitoring, ECG +/- defib; Bloods: VBG, FBC, UEC. Chest compression if indicated. Consider IV fluid resuscitation, replace like-with-like if blood loss. Look for cause of PPH
D - GCS, AVPU - may guide need for intubation
E - Exposure, Temperature
F - separate team should be assessing and managing the foetus.
G -
Maternal collapse - Management
Management
