18 - Sudden postpartummaternal collapse

Summary

Maternal collapse is an acute event involving the cardiorespiratory system and/or brain, resulting in a reduced or absent consciousness level (and potentially death), in the immediate period following delivery and up to 6 weeks after delivery. The use of an Early Warning Score system modified for pregnancy (MEOWS) is being encouraged for early recognition of acutely unwell women. Circulatory arrest is diagnosed by absence of a palpable carotid or femoral pulse and resuscitation with external chest compressions should be commenced immediately. Circulatory collapse secondary to haemorrhagic shock is one of the leading causes of postpartum collapse. Glasgow Coma Scale can be used as an objective assessment of patient's level of consciousness. Automated external defibrillators or external monitors to assess cardiac rhythm should be applied as per advanced life-support guideline. Early involvement of relevant specialists should be encouraged to maintain high standards of care and reduced maternal morbidity and mortality.