• Obstetric emergencies
    • Classification
      • 1
        • Immediate threat to mother/fetus
      • 2
        • Maternal/fetal compromise but not immediately life threatening
      • 3
        • Early delivery but no maternal/fetal compromise
      • 4
        • At time to suit dept and woman
    • Class 1
      • Cord prolapse
      • Profound fetal distress
        • FHR < 70 and pH<7 then immediate delivery advised
        • Relieve aorto-caval compression
        • Fluids, stop oxytocin, oxygen, treat maternal hypotension
        • Left lateral
      • Haemorrhage
        • > 40% blood loss or > 2L
        • DIC is common in abruption (esp >2.5L)
    • Anaesthetic complications
      • General anaesthesia
        Link:ceaccp.oxfordjournals.org/content/9/5/148.full.pdf
      • Regional
        • Hypotension
        • High spinal
        • LA toxicity
    • Maternal collapse
      • Cardiac arrest
        • Delivery after 5 mins of unsuccessful CPR
        • Left lateral tilt
      • Embolism
        • 25% of maternal deaths
        • Includes AFE
      • Convulsion
        • Often due to eclampsia
        • Consider CNS infections
      • Sepsis
        • β-haemolytic strep common
        • Resus and stabilisation are key
      • Uterine rupture
        • Consider especially during VBAC
      • Pre-eclamptic toxaemia
        • Can lead to ICH, pulmonary oedema and MI
        • Severe if SBP >170, DBP >110 with proteinuria or lower BP with other symptoms
        • Beware of input over 80ml/hr
        • Labetalol, Hydralazine and nifedipine are used
    • CEACCP
      Link:www.ceaccp.oxfordjournals.org/content/2/6/174.full.pdf