Obstetric Emergencies (DRAFT)

2018 ◽  
Author(s):  
Amir Shamshirsaz ◽  
David Muigai
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Lateral Displacement ◽  
Rapid Response Team ◽  
Obstetric Patient ◽  
Response Team ◽  
Obstetric Emergencies ◽  
Perimortem Cesarean Section ◽  
Maternal Cardiopulmonary Resuscitation

An obstetric rapid response team (RRT) should ideally include the readily available presence of an obstetrician and a well-established system for escalation of care and management of the fetus where applicable. During the evaluation of an obstetric patient, the RRT team should be familiar with the unique changes in maternal pregnant physiology and their influence on the presentation and management of common maternal emergencies. Postpartum hemorrhage, pre-eclampsia related complications, and sepsis together form the bulk of causes for maternal RRT calls. The knowledge of, and competence with, left lateral displacement of the uterus and the timing and execution of perimortem cesarean section are essential during maternal cardiopulmonary resuscitation. In this chapter, we review common maternal emergencies during RRT activation and their management.

scholarly journals Listas de chequeo en obstetricia: ayudas cognitivas que salvan vidas

2020 ◽  
Vol 80 (04) ◽  
pp. 292-302
Author(s):  
Juan Pérez-Wulff ◽  
◽  
Daniel Márquez ◽  
Jesús Veroes ◽  
Jonel Di Muro ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Magnesium Sulfate ◽  
Postpartum Hemorrhage ◽  
Obstetrics And Gynecology ◽  
Emergency Rooms ◽  
Additional Tool ◽  
Expert Opinions ◽  
Hypertensive Pregnancy ◽  
Maternal Cardiopulmonary Resuscitation ◽  
Pregnancy Disorders

Objective: To propose the use of eight checklists in the country’s obstetric emergency rooms. Methods: An interdisciplinary team was established with physicians specializing in obstetrics and gynecology, perinatology, fetal maternal medicine, critical medicine, anesthesiology, infectology and neonatology. Upon determination of the main pathologies affecting maternal mortality in Venezuela, multiple checklists used in different centers worldwide, publications available in databases and expert opinions were reviewed. They adapted to the realities of the country and medical availability and prioritized medical actions, laboratory tests, drug treatment and diagnostic elements. Results: Checklists for postpartum hemorrhage, obstetric sepsis, hypertensive pregnancy disorders (preeclampsia with signs of severity and eclampsia), magnesium sulfate poisoning, placental acretism, maternal cardiopulmonary resuscitation, and trauma and pregnancy are presented. Conclusion: The checklists resulting from the initiative of the Society of Obstetrics and Gynecology of Venezuela are available to all health personnel who require them for implementation in educational simulation scenarios and in clinical practice, as an additional tool for finding better outcomes in patients who require high complexity management in maternity rooms. Keywords: Checklist, Postpartum hemorrhage, Obstetric sepsis, Hypertensive pregnancy disorders, Magnesium sulfate poisoning, Placental acretism, Maternal cardiopulmonary resuscitation, Trauma and pregnancy

scholarly journals Out-of-Hospital Perimortem Cesarean Section as Resuscitative Hysterotomy in Maternal Posttraumatic Cardiac Arrest

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Francesca Gatti ◽  
Marco Spagnoli ◽  
Simone Maria Zerbi ◽  
Dario Colombo ◽  
Mario Landriscina ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cesarean Section ◽  
Surgical Intervention ◽  
Hemodynamic Instability ◽  
Spontaneous Circulation ◽  
Traditional Treatment ◽  
Return Of Spontaneous Circulation ◽  
Traumatic Cardiac Arrest ◽  
Perimortem Cesarean Section

The optimal treatment of a severe hemodynamic instability from shock to cardiac arrest in late term pregnant women is subject to ongoing studies. However, there is an increasing evidence that early “separation” between the mother and the foetus may increase the restoration of the hemodynamic status and, in the cardiac arrest setting, it may raise the likelihood of a return of spontaneous circulation (ROSC) in the mother. This treatment, called Perimortem Cesarean Section (PMCS), is now termed as Resuscitative Hysterotomy (RH) to better address the issue of an early Cesarean section (C-section). This strategy is in contrast with the traditional treatment of cardiac arrest characterized by the maintenance of cardiopulmonary resuscitation (CPR) maneuvers without any emergent surgical intervention. We report the case of a prehospital perimortem delivery by Caesarean (C) section of a foetus at 36 weeks of gestation after the mother’s traumatic cardiac arrest. Despite the negative outcome of the mother, the choice of performing a RH seems to represent up to date the most appropriate intervention to improve the outcome in both mother and foetus.

scholarly journals Perimortem Cesarean Section : As Resucitative Hysterotomy On Maternal Cardiac Arrest

2020 ◽  
Vol 4 (2) ◽  
pp. 218-230
Author(s):  
Madona Utami Dewi ◽  
Syahredi Syaiful Adnani ◽  
Emilzon Taslim
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cesarean Section ◽  
Tension Pneumothorax ◽  
Pregnant Patient ◽  
Volume Resuscitation ◽  
Consciousness Level ◽  
Perimortem Cesarean Section ◽  
Acute Event ◽  
In Pregnancy

Maternal cardiac arrest or maternal collaps is defined as an acute event involving the cardiorespiratory systems and/or brain, resulting in a reduced or absent consciousness level (and potentially death), at any stage in pregnancy and up to six weeks after delivery. Perimortem Cesarean Section (PCS) is performed either during maternal cardiac arrest or during impending maternal cardiac arrest toresuscitate mother and fetal. Current recommendations for maternal resuscitation include performance of the procedure following five minutes of unsuccessful cardiopulmonary resuscitation. The most common aetiology of maternal collaps was know as “4 H and  4 T” (Hypovolemia, Hypoxia, Hypo/Hyperkalemia,Hypothermia; Tromboembolism, Toxicity, Tension pneumothorax, Tamponade). Resuscitation in maternal cardiac arrest is mostly similar with non-pregnant patient resuscitation. There are several considerations need to be addressed in primary survey such as endotracheal tube 1 size smaller, supplemental O2 regardless of peripheral saturation, aggressive volume resuscitation, and uterine displacement to relieve compression of the IVC.Keywords: Maternal cardiac arrest; non-pregnant patient resuscitation

scholarly journals Effects of a Rapid Response Team on the Clinical Outcomes of Cardiopulmonary Resuscitation of Patients Hospitalized in General Wards

2021 ◽  
Vol 28 (4) ◽  
pp. 491-499
Author(s):  
Mi-Jung Yoon ◽  
Jin-Hee Park
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Clinical Outcomes ◽  
Rapid Response Team ◽  
Rapid Response ◽  
Exact Test ◽  
Limited Operation ◽  
Operation Period ◽  
Response Team ◽  
Extended Operation ◽  
General Wards

Purpose: This study investigated differences in the clinical outcomes of cardiopulmonary resuscitation (CPR) of patients hospitalized in general wards according to the operation of a rapid response team.Methods: This retrospective study included 122 patients over the age of 19 who were admitted to general ward of a hospital located in Suwon, between July 1, 2015 and December 31, 2019, and received CPR during the operating hours of the rapid response team. The collected data were analyzed by descriptive statistics, the x2 test, Fisher's exact test, and one-way analysis of variance using SPSS for Windows version 25.0.Results: The proportion of nurses who were the initial responders to cardiac arrest was 79.1% during the extended-operation period. 41.2% during the pre-operation period, and 42.2% during the limited-operation period (p<.001). The rate of good neurological recovery at discharge post-CPR was 25.0% in patients who received CPR during the pre-operation period, 36.4% during the limited-operation period, and 87.5% during the extended-operation period (p=.042).Conclusion: This study identified clinical outcomes in patients who received CPR according to the operation status of the rapid response team. These results are expected to help in the further implementation of rapid response teams.

scholarly journals Perimortem Cesarean Section : As Resucitative Hysterotomy On Maternal Cardiac Arrest

2020 ◽  
Vol 4 (2) ◽  
pp. 249-261
Author(s):  
Madona Utami Dewi ◽  
Syahredi Syaiful Adnani ◽  
Emilzon Taslim
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cesarean Section ◽  
Tension Pneumothorax ◽  
Pregnant Patient ◽  
Volume Resuscitation ◽  
Consciousness Level ◽  
Perimortem Cesarean Section ◽  
Acute Event ◽  
In Pregnancy

Maternal cardiac arrest or maternal collaps is defined as an acute event involving the cardiorespiratory systems and/or brain, resulting in a reduced or absent consciousness level (and potentially death), at any stage in pregnancy and up to six weeks after delivery. Perimortem Cesarean Section (PCS) is performed either during maternal cardiac arrest or during impending maternal cardiac arrest toresuscitate mother and fetal. Current recommendations for maternal resuscitation include performance of the procedure following five minutes of unsuccessful cardiopulmonary resuscitation. The most common aetiology of maternal collaps was know as “4 H and  4 T” (Hypovolemia, Hypoxia, Hypo/Hyperkalemia,Hypothermia; Tromboembolism, Toxicity, Tension pneumothorax, Tamponade). Resuscitation in maternal cardiac arrest is mostly similar with non-pregnant patient resuscitation. There are several considerations need to be addressed in primary survey such as endotracheal tube 1 size smaller, supplemental O2 regardless of peripheral saturation, aggressive volume resuscitation, and uterine displacement to relieve compression of the IVC.Keywords: Maternal cardiac arrest; non-pregnant patient resuscitation

Mise en place et organisation d’une équipe médicale mobile de réponse précoce aux urgences intra-hospitalières (Rapid Response Team)

2020 ◽  
Author(s):  
Boris Jung ◽  
Gerald Chanques ◽  
Samir Jaber ◽  
Kada Klouche
Keyword(s):  
Rapid Response Team ◽  
Rapid Response ◽  
Prise En Charge ◽  
Response Team

La mise en place d’une Rapid Response Team a pour objectif la mise en place d’une structure de réponse hospitalièrepour la prise en charge des urgences vitales et surtout une réponse précoce à la dégradation clinique des patientshospitalisés avant que l’urgence vitale ne survienne. Nous discutons dans ce manuscrit le rationnel et le niveau depreuve motivant la mise en place d’une Rapid Response Team ainsi que les freins qui doivent être surmontés pour lesuccès de cette mise en place.

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