Maternal Collapse in pregnancy and puerpieum GTG Flashcards
Rates of maternal cardiac arrest?
1 in 36,000
Case fatality of maternal cardiac arrest?
42%
What % of maternal cardiac arrest are secondary to anaesthesia? What are the survival rates of these?
25%
100%
What is the most common cause of maternal collapse?
Haemorrhage, always consider concealed haemorrhage
What is the most common cause of direct maternal death?
VTE
Marernal Survival rates of AFE?
81%
Perinatal mortality rate in AFE
67/1000
Most common cause of indirect maternal death?
Cardiac disease
In anaphylaxis when should mast cell try-taste be taken?
As soon as possible
1-2 hrs after Sx
24hrs later
Causes of maternal collapse
Plasma volume increases by how much?
50%, dilution anaemia
Heart rate increases by how much?
15-20 bpm
Cardiac output increases by how much?
40%, reduced by pressure on IVC
how much of blood flow does to uterus at term
10%, risk of massive haemorrhage
Oxygen consumption increases by how much?
20%
Residual capacity changed by how much?
Reduced by 25%
Aortocaval compression from 20 weeks, reduced cardiac output by how much?
30-40%, manual displacement of uterus from 20 weeks
When should perimortum CS take place?
If no ROSC within 4 mins
Performed by 5 mins
What % of fetus survived with perimortum CS peformed within 5 mins
69%
Antidote to magnesium toxicity?
antidote to magnesium toxicity is 10 ml 10% calcium gluconate or 10 ml 10% calciumchloride given by slow intravenous injection
Antidote to local anaesthetic toxicity
Intra-lipid 20%
20% 1.5 ml/kg over 1 min (100 ml for a woman weighing 70 kg) followed by an intravenous infusion of Intralipid 20% 15 ml/kg/h (1000 ml.h1for a woman weighing 70 kg). The bolus injection can be repeated twice at 5-minuteintervals if an adequate circulation has not been restored (a further two 100 ml boluses at 5-minuteintervals for a woman weighing 70 kg).
How much adrenaline is given for anaphylaxsis
Anaphylaxis is 1:1000 adrenaline 500 micrograms (0.5 ml) intramuscularly
Can be repeated after 5 min if no effect
Chlorphenamine 10mg
Hydrocortisone 200mg
IM or IV
From which gestation of antepartum collapse should Paeds be called?
From 22 weeks
What is the rate and number of chest compressions?
30 compression rate 100/min, 5-6cm at centre of chest
2 ventilation
Which rhythms are shockable?
VF/pulseless VT
What shock is given
200 J biphasic
360 J monophonic
How often should adrenaline be given?
Every 3-5 mins
1mg 1:10,000
