Maternal Collapse Flashcards
Maternal collapse definition
An acute event involving the cardioresp systems and/or brain, resulting in a reduced or absent conscious level (also death), at any stage in pregnancy and up to 6 weeks PP
Obstetric Causes of maternal collapse
Haemorrhage Eclampsia PE Uterine inversion Uterine rupture Intrauterine-abdominal bleeding Genital tract haematoma AFE s
Physiological and anatomical changes in pregnancy that affect resuscitation
Aortocaval compression - reduces CO and reduces effectiveness of chest compressions
Increased RR, increased o2 consumption, diaphragmatic splinting (reduced FRC)
Difficult intubation
Aspiration - relaxation of LES
Circulation- uterus receives 10% of total CO
When to do perimortem section
No response to correctly performed CPR within 4 minutes of maternal collapse or resuscitation is continued beyond this
Should deliver within 5 minutes of collapse
Evidence for perimortem section
Irreversible brain damage at 4-6min
Del reduces o2 consumption, improves venous return and CO, facilitates chest compressions and makes ventilation easier
Treatment of LA toxicity
Intralipid 20%
Septic shock causes
Chorio Pyelonephritis Chest infection Meningitis Appendicitis Cholecystitis Pancreatitis
SIRS- systemic inflammatory response syndrome
2 or more of Temp >38 or <36 Tachycardia Tachypnoea WCC>11 or < 4
Non-obstetric causes of collapse
Arrhythmia MI Cardiomyopathy Hypoglycemia Aortic dissection Anaphylaxis Drugs:mgso4, LA, illicit drug Metabolic or endocrine cause Septic shock CVA SAH
Shock
A life-threatening condition of circulatory failure, causing inadequate oxygen delivery to meet cellular metabolic needs and oxygen consumption requirements, producing cellular and tissue hypoxia
Possible causes of maternal collapse (5Hs)
Head Heart Hypoxia Haemorrhage wHole body hazards
4H’s 4Ts
Hypovolaemia Hypoxia Hypo/hyper electrolyte disturbances Hypothermia thromboembolism Toxicity Tension pneumothorax Tamponads
