Cardiac arrest in pregnancy Flashcards
(10 cards)
What are the reversible causes of adult cardiac arrest?
4Ts: thrombosis, tension pneumothorax, toxins, tamponade; 4Hs: hypoxia, hypovolaemia, hypothermia, hyperkalaemia, hypoglycaemia
What are the three main causes of cardiac arrest in pregnancy?
- Obstetric haemorrhage 2. Pulmonary embolism 3. Sepsis leading to metabolic acidosis & septic shock
Why is obstetric haemorrhage a major cause of cardiac arrest?
Causes severe hypovolaemia
What causes obstetric haemorrhage?
Ectopic pregnancy; Placental abruption; Placenta praevia; Placenta accreta; Uterine rupture
What is aortocaval compression?
After 20 weeks gestation, if women lie on their back, the mass of the uterus can compress the inferior vena cava and aorta. Compression on vena cava means it reduces the blood returning to the heart → reduces cardiac output → hypotension. This can be enough to lead to cardiac arrest.
How can you solve aortocaval compression?
Place the woman in the left lateral position to relieve the compression of the inferior vena cava.
What makes resuscitation more complicated in pregnancy?
Aortocaval compression; Increased O2 requirements; Splinting of diaphragm by pregnant abdomen; Difficulty with intubation; Increased risk of aspiration; Ongoing obstetric haemorrhage
How do you do resuscitation in pregnancy?
A 15 degree tilt to the left side for CPR; Early intubation; Early supplementary oxygen; Aggressive fluid resuscitation; Delivery of baby after 4 mins and within 5 mins of starting CPR
When do you perform immediate C section?
No response after 4 minutes to CPR performed correctly; CPR continues for more than 4 minutes in a woman more than 20 weeks gestation
Why do you have to perform immediate C section?
Improves survival of mother & baby; Delivery improves venous return to the heart, improves cardiac output and reduces oxygen consumption; Also helps with ventilation & chest compressions
