O&G Cases · Critical care — maternal physiology
Critically ill pregnant woman — physiology-modified resuscitation station
Resuscitation station on a pregnant woman with severe pneumonia and evolving type 2 respiratory failure on a background of pregnancy physiology. Tests ABG interpretation against pregnant references, the modified resuscitation (left lateral position, preoxygenation, balanced crystalloid, early sepsis bundle), the drug-dosing implications, and the disposition decision. Includes assessor key and marking domains.
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Station brief
Format. Resuscitation and physiology-defence station, approximately 12 minutes. You are the obstetric registrar. The ED registrar and a midwife are with you; the obstetric consultant is 15 minutes away and has been called. The assessor will run the clock and feed you new observations. [4]
Candidate instruction. Lead the assessment of a pregnant woman with severe pneumonia, defending the pregnant reference ranges against non-pregnant interpretation. Verbalise the physiology, the modified resuscitation algorithm, the drug-dosing implications, and the disposition decision. [1][4]
References4ShowHide
- [1]Costantine MM Physiologic and pharmacokinetic changes in pregnancy Front Pharmacol, 2014.PMID 24772083
- [2]Hegewald MJ, Crapo RO Respiratory physiology in pregnancy Clin Chest Med, 2011.PMID 21277444
- [3]Conrad KP, Davison JM The renal circulation in normal pregnancy and preeclampsia: is there a place for relaxin? Am J Physiol Renal Physiol, 2014.PMID 24647709
- [4]Chu J, Johnston TA, Geoghegan J Maternal Collapse in Pregnancy and the Puerperium: Green-top Guideline No. 56 BJOG, 2020.PMID 31845507