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2 results

  • 3.9.1 - Obstetric Emergencies

  • from Section 3.9 - Obstetrics and Maternal Peripartum Complications
  • Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
  • Book:
    Intensive Care Medicine
    Published online:
    27 July 2023
    Print publication:
    01 December 2021, pp 307-315

  • Summary

    Key Learning Points

    1. 1. Critical illness in pregnancy is relatively uncommon; however, it carries a significant amount of morbidity and mortality when it does occur. The majority of patients will be admitted to the intensive care unit in the post-partum period.

    2. 2. Recent advances in the management of common direct obstetric causes of maternal critical illness have improved outcomes. Unfortunately, however, we have not seen similar advances in treating the indirect causes.

    3. 3. Managing this unique cohort of patients is challenging and requires an in-depth knowledge of both maternal physiological adaptations to pregnancy and how these may affect the course of the patient’s illness.

    4. 4. In obstetric emergencies, the main priority must be to resuscitate the mother, which, in turn, will help resuscitate the fetus.

  • 4 - Massive obstetric haemorrhage

  • Edited by Ann Harper
  • Book:
    Haemorrhage and Thrombosis for the MRCOG and Beyond
    Published online:
    05 October 2014
    Print publication:
    01 June 2005, pp 42-58

  • Summary

    Massive obstetric haemorrhage is usually due to placenta praevia, premature placental separation or postpartum causes and is often associated with coagulopathy. Most maternal deaths associated with ectopic pregnancy, which is the most common cause of death in early pregnancy, are due to haemorrhage. Many women who have died from ectopic pregnancy presented with symptoms of urinary or gastrointestinal conditions. The main causes of antepartum haemorrhage are placenta praevia and placental abruption. A high incidence of false positive diagnosis of placenta praevia is associated with second-trimester transabdominal ultrasound scans. The most common cause of primary postpartum haemorrhage is uterine atony. The signs and symptoms of secondary postpartum haemorrhage include a rising pulse rate, falling blood pressure, pallor, sweating, restlessness and oliguria. Haemorrhage can occur suddenly and unexpectedly in any woman. However, some women are at increased risk of bleeding.