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Chapter 12 - Acute collapse and resuscitation

from Section 2 - General medical considerations

Published online by Cambridge University Press:  05 July 2013

Marc van de Velde
Affiliation:
University Hospital Leuven
Helen Scholefield
Affiliation:
Liverpool Women's Hospital
Lauren A. Plante
Affiliation:
Drexel University College of Medicine
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Summary

Maternal collapse includes a variety of acute life threatening events involving maternal cardiorespiratory or central nervous systems. Maternal resuscitation follows standard Advanced Cardiac Life Support (ACLS) guidelines with a limited number of pregnancy-specific alterations. The primary variation from non-pregnancy guidelines is the requirement to displace the gravid uterus laterally to increase cardiac output. Cardiac output during closed chest massage in cardiopulmonary resuscitation (CPR) is approximately 30% of normal. Traditionally, displacement of the gravid uterus has been done by maternal tilt from 15° to 30° to facilitate increased venous return and cardiac output. Immediate awareness of the need to perform perimortem cesarean delivery 4 minutes after persistent cardiopulmonary arrest and the availability of an emergency kit for surgery can result in faster delivery of the baby, faster return of the maternal circulation, and better clinical outcomes for both mother and child.
Type
Chapter
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Maternal Critical Care
A Multidisciplinary Approach
, pp. 134 - 142
Publisher: Cambridge University Press
Print publication year: 2013

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