Maternal Collapse Flashcards
causes of maternal collapse
5H’s
- head
- heart
- hypoxia
- haemorrhage
- wHole body and hazards
head causes of maternal collapse
eclampsia
epilepsy
cerebrovascular accident
vasovagal response
heart causes of maternal collapse
MI
arrhythmias
peripartum cardiomyopathy
hypoxia causes of maternal collapse
asthma
PE
pulmonary oedema
anaphylaxis
haemorrhage causes of maternal collapse
abruption atony trauma uterine rupture uterine inversion aneurysm
whole body and hazard causes of maternal collapse
hypoglycaemia amniotic fluid embolism septicaemia trauma anaesthetic complications drug overdose
reversible causes of cardiac arrest in pregnancy
4T’s, 4H’s and 2C’s (eclampsia and intracerebral bleed)
management of collapse
ABCDE
resuscitation
perimortem C/S
drugs
complications in resuscitation of a pregnant woman
- gravid uterus= from 20 weeks when supine the uterus compresses IVC and aorta reducing venous return causing hypotension
- foetus steals oxygen
- difficult to intubate as progesterone softens muscles (UOS)
management of gravid uterus
left lateral lie and do manual uterine displacement
when should a perimortem C/S be done?
if no response to CPR within 4 minutes
continue CPR throughout
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
local anaesthetic toxicity 1.5ml 20% intralipid
what is an amniotic fluid embolism?
usually in labour when the amniotic fluid enters the maternal circulation
presentation of amniotic fluid embolism
foetal distress
sudden respiratory distress
seizure
DIC
what is a cord prolpase?
cord leaves before the baby
amniotic sac ruptures early and there is direct compression and cord spasm causing hypoxia
management of cord prolapse
immediate C/S
what is shoulder dystocia?
bony impaction of foetal anterior shoulder and maternal pubic symphysis
presentation of shoulder dystocia
head bobbing
turtle sign
management of shoulder dystocia
do not pull harder
McRobert’s manoeuvre or suprapubic pressure
Erb’s palsy check
