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O&G CasesIntrapartum care — medical comorbidity

O&G Cases · Intrapartum care — medical comorbidity

Cardiac disease in labour — emergency management and planning station

Emergency-management and planning station on a cardiac woman decompensating in labour: candidate leads the recognition of pulmonary oedema, the condition-specific resuscitation, the decision about mode and timing of birth, and the postpartum surveillance plan. Includes assessor timeline, marking domains, assessor key and fail criteria.

resus3 min readVerification in progress

Target exams

FRANZCOGMRCOGABOG
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Target exams

FRANZCOGMRCOGABOG
Prompt
A 33-year-old G2P1 with severe aortic stenosis (modified WHO class III) is in spontaneous labour at 39 weeks. A written multidisciplinary plan exists. During the second stage she becomes breathless, her oxygen saturation falls, and she cannot lie flat. The anaesthetist and cardiology registrar are contactable. You are the obstetric registrar.

Station brief

Format. Emergency-management and planning station, approximately 12 minutes. You are the obstetric registrar on a birth suite with an anaesthetist and a cardiology registrar contactable. A midwife is with the patient. The assessor runs the clock and feeds new observations. [4]

Candidate instruction. Recognise and manage the decompensation, lead the team, defend your decisions about mode and timing of birth, and plan the postpartum surveillance. Verbalise your actions and your communication with the team. [4]

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References2ShowHide
  1. [4]Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J, 2018.PMID 30165544
  2. [5]Ruys TP, Roos-Hesselink JW, Pijuan-Domènech A, et al. Is a planned caesarean section in women with cardiac disease beneficial? Heart, 2015.PMID 25539946
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