Obstetric emergencies

Gleeson, Claire; Scrutton, Mark

doi:10.1016/j.mpaic.2008.01.003

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Volume 9, Issue 3 , Pages 115-121, March 2008

Obstetric emergencies

Claire Gleeson, FRCA, is a final-year Specialist Registrar on the Bristol rotation. She has also trained at University College and Middlesex School of Medicine and St Thomas' Hospital, London. Her interests include obstetric anaesthesia

Mark Scrutton, FRCA, is Consultant Anaesthetist and Clinical Lead for Obstetric Anaesthesia at the United Bristol Healthcare NHS Trust. He trained at St Thomas' Hospital and St George's Hospital, London. His interests include anaesthesia for high-risk pregnancy and multidisciplinary obstetric emergency training

Abstract

The two most recent Confidential Enquiries into Maternal and Child Health reports, examining Maternal Mortality in the UK, demonstrate that haemorrhage, hypertensive disease, amniotic fluid embolus and sepsis remain the most important direct causes of death after thromboembolic disease. Cardiac disease is the most important indirect cause of maternal death. Substandard care is adjudged to have contributed to more than 50% of all maternal deaths, and the reports highlight the importance of multidisciplinary care. This article addresses some of the key issues in the management of obstetric emergencies and emphasizes the importance of multidisciplinary teamwork and fire drills.

Keywords: haemorrhage, obstetric anaesthesia, pre-eclampsia, resuscitation