Maternal Resuscitation

Question 1

Potential causes

Answer 1

• Eclampsia
• ICH
• PE, MI, Aortic Dissection
• Sepsis
• Haemorrhage

Question 2

Cardiovascula changes hindering resuscitation?

Answer 2

50% added plasma volume, reduced O2 carrying capacity.

Higher HR, increased CPR demand.

10% of cardiac output in uterine blood flow, potential for massive haemorrhage.

Question 3

Respiratory changes hindering resuscitation?

Answer 3

Increased RR - decreased buffering capacity, ^acidosis.

Increased O2 consumption - hypoxia happens quicker.

Question 4

Other changes hindering resuscitation?

Answer 4

Decreased gastric mobility -> aspiration risk higher.

Increased weight -> large breasts may affect intubation / make ventilation more difficult.

Question 5

Important adjustments

Answer 5

Push uterus to maternal left to minimise IVC pressure & facilitate venous return; manual displacement if possible.

Higher hand position due to gravid uterus

May need bi-axillary or anteroposterior pads

If no response after 5 miuntes, time critical transfer to ED.