Maternal Collapse Flashcards
1
Q
Definition
A
- An acute event involving the cardiorespiratory systems and/or brain, resulting in a reduced or absent conscious level (and potentially death), at any stage in pregnancy and up to six weeks after delivery
2
Q
Management of collapse
A
NB - during CPR use manual left lateral uterine displacement to prevent aortocaval compression and improve outcome
3
Q
CVS considerations in the pregnant patient
A
- Plasma volime increased so dilutional anaemia and reduced O2 carrying capacity
- HR increased so increased CPR demands
- Cardiac output increased so increased CPR demands
- Uterine blood flow is 10% of cardiac output at term so potential for rapid massive haemorrhage
- Systemic vascular resistance decreased so sequesters blood during CPR
- BP decreased so decreased reserve
- Venous return decreased by pressure of uterus on IVC so increased CPR demands and decreased reserve
4
Q
Respiratory considerations in the pregnant patient
A
- RR increased so decreased buffering capacity and acidosis more likely
- O2 consumption increased so hypoxia develops faster
- Decreased residual capacity so decreased buffering capacity and acidosis more likely
- Decreased arterial PCO2 so decreased buffering capacity and acidosis more likely
- Laryngeal oedema increased so difficult intubation
5
Q
Other considerations in the pregnant patient
A
- Gastric motility decreased so risk of aspiration
- Lowed oesophageal sphincter relaxed so risk of aspiration
- Uterus enlarged which splints diaphragm reducing residual capacity and makes ventilation more difficult
- Weight increased which can affect ventilation
6
Q
Perimorten caesarean section
A
- Perform is no response to CPR after 4 minutes
- Aim for delivery by 5 minutes
- No anaesthetic required
- Primarily to save mother’s life
- Increase venous return
- Improves ease of ventilation
- Allow CPR in supine position
- Reduced O2 requirement following delivery
7
Q
Reversible causes in pregnancy (remember 4 H’s and 4 T’s)
A
