Maternal Collapse in pregnancy and puerpieum GTG

Question 1

Rates of maternal cardiac arrest?

Answer 1

1 in 36,000

Question 2

Case fatality of maternal cardiac arrest?

Answer 2

42%

Question 3

What % of maternal cardiac arrest are secondary to anaesthesia? What are the survival rates of these?

Answer 3

25%
100%

Question 4

What is the most common cause of maternal collapse?

Answer 4

Haemorrhage, always consider concealed haemorrhage

Question 5

What is the most common cause of direct maternal death?

Answer 5

VTE

Question 6

Marernal Survival rates of AFE?

Answer 6

81%

Question 7

Perinatal mortality rate in AFE

Answer 7

67/1000

Question 8

Most common cause of indirect maternal death?

Answer 8

Cardiac disease

Question 9

In anaphylaxis when should mast cell try-taste be taken?

Answer 9

As soon as possible
1-2 hrs after Sx
24hrs later

Question 10

Causes of maternal collapse

Answer 10

Question 11

Plasma volume increases by how much?

Answer 11

50%, dilution anaemia

Question 12

Heart rate increases by how much?

Answer 12

15-20 bpm

Question 13

Cardiac output increases by how much?

Answer 13

40%, reduced by pressure on IVC

Question 14

how much of blood flow does to uterus at term

Answer 14

10%, risk of massive haemorrhage

Question 15

Oxygen consumption increases by how much?

Answer 15

20%

Question 16

Residual capacity changed by how much?

Answer 16

Reduced by 25%

Question 17

Aortocaval compression from 20 weeks, reduced cardiac output by how much?

Answer 17

30-40%, manual displacement of uterus from 20 weeks

Question 18

When should perimortum CS take place?

Answer 18

If no ROSC within 4 mins
Performed by 5 mins

Question 19

What % of fetus survived with perimortum CS peformed within 5 mins

Answer 19

69%

Question 20

Antidote to magnesium toxicity?

Answer 20

antidote to magnesium toxicity is 10 ml 10% calcium gluconate or 10 ml 10% calciumchloride given by slow intravenous injection

Question 21

Antidote to local anaesthetic toxicity

Answer 21

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).

Question 22

How much adrenaline is given for anaphylaxsis

Answer 22

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

Question 23

From which gestation of antepartum collapse should Paeds be called?

Answer 23

From 22 weeks

Question 24

What is the rate and number of chest compressions?

Answer 24

30 compression rate 100/min, 5-6cm at centre of chest
2 ventilation

Question 25

Which rhythms are shockable?

Answer 25

VF/pulseless VT

Question 26

What shock is given

Answer 26

200 J biphasic
360 J monophonic

Question 27

How often should adrenaline be given?

Answer 27

Every 3-5 mins

1mg 1:10,000