Maternal collapse and resuscitation in pregnancy

The emergency buzzer goes at 21:40 and you arrive to a 33-year-old two hours after a caesarean, grey, unresponsive, with a midwife shaking her shoulder. Nobody is compressing. Nobody has said the word "arrest". Everything that happens in the next sixty seconds is decided by whether you take the room — and by whether you know the four things that are different about resuscitating a pregnant woman.[1][4]

Overview and definition

RCOG Green-top Guideline 56 gives the definition worth quoting verbatim: an acute event involving the cardiorespiratory systems and/or brain, resulting in a reduced or absent conscious level (and potentially death), at any stage in pregnancy and up to six weeks after birth.[1]

Two words in that definition do the work. "Potentially" — collapse is not synonymous with arrest, and most collapsed women still have a pulse. "Six weeks" — the postnatal woman at home is still an obstetric patient, and the causes shift as the weeks pass.[1][4]

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