Maternal collapse / cardiac arrest

Act

1. Shout for help: obstetric + cardiac arrest teams; note time.
2. No signs of life: CPR 30:2.
3. ≥20 weeks: manual left uterine displacement.
4. Early airway by anaesthetist; high-flow O2; IV access above diaphragm.
5. Defibrillate and give drugs as for any adult (adrenaline 1 mg every 3–5 min).
6. No ROSC by 4 min (≥20 wk): perimortem CS — baby out by 5 min.

Think (4 Hs, 4 Ts + obstetric)

• Haemorrhage, eclampsia, sepsis, amniotic fluid embolism
• Thromboembolism, MgSO4 or LA toxicity
• Hypoxia, hypovolaemia, hypo/hyperkalaemia, hypothermia
• Tension pneumothorax, tamponade, toxins, thrombosis