Cardiovascular emergencies and cardiac arrest in a pregnant woman

Publication date: Available online 5 July 2016 Source:Anaesthesia Critical Care & Pain Medicine Author(s): Anne-Sophie Ducloy-Bouthors, Max Gonzalez-Estevez, Benjamin Constans, Alexandre Turbelin, Catherine Barre-Drouard Points essentiels Any dyspnoea, chest pain, syncope or collapsus must alert women health care providers to engage rapidly the diagnosis process and emergent treatment of the cardio-circulatory failure. The larger competence of the obstetric anaesthetists to perform echographic diagnosis at the parturient bedside helps to a more rapid management than previously. Symptomatic and etiologic treatments must be applied without delay induced by the pregnant status and obstetrical manoeuvres. Haemodynamic management must be guided by a strict continuous monitoring. Non-invasive cardiac output monitoring is now available to allow this follow-up. Cardiac arrest (CA) management in a pregnant woman is based on: Oxygenation, intubation, ventilation, cardiac massage accompanied by left uterus displacement to increase right ventricular preload, intravenous epinephrine and electrical cardioversion changing palette axis to avoid the foetus, Caesarean section within 4minutes if CA persists. Cardiac arrest is a good indication for Extracorporeal Cardiac Life Support, especially in amniotic fluid embolism. ECLS is also indicated in severe failures if symptomatic and aetiologic treatments are inefficient: peripartum cardiomyopathy, acute respiratory distre...

Source: Anaesthesia, Critical Care and Pain Medicine - July 21, 2016 Category: Anesthesiology Source Type: research