CH 18 Cardiac Arrest Associated with Pregnancy

removal of the fetus from the gravid uterus

After approximately 20 weeks of gestation, the key to resuscitation of the mother is possibly WHAT

subdiaphragmatic

Because there is obstruction of venous return in the pregnant patient, you should not administer resuscitation medications through a WHAT vein

20

Beginning at HOW MANY weeks of gestation, the uterus is known to compress the inferior vena cava and aorta, compromising systemic venous return and systemic blood flow

spinal shock

Cardiac arrest can occur from WHAT as a result of regional anesthesia in the pregnant woman

40%

During most of the pregnancy, there is a HOW MUCH increase in cardiac output and plasma volume

placenta

During pregnancy the uterus and WHAT form a passive, low-resistance system

Neurologic effects, such as loss of tendon reflexes, sedation, severe muscular weakness, and respiratory depression, are seen at Mag levels of 4-5 mmol/L

Excess magnesium sulfate in pregnancy can be indicated by WHAT?

umbilicus

If the fundus height is at or above the level of the WHAT, manual LUD can be beneficial in relieving ACC during chest compressions

4 , 5

If the mother remains in cardiac arrest and unresponsive to BLS and ACLS by WHAT min; then delivery of the fetus by WHAT min will relieve the obstruction on the inferior vena cava and the aorta and may enable successful resuscitation of the mother

perimortem cesarean delivery (PMCD)

In the latter half of pregnancy, WHAT may be considered part of maternal resuscitation, regardless of fetal viability, especially with consideration of Aortacaval Compression (ACC)

30min

Neonatal survival has been documented with PMCD performed up to HOW LONG after the onset of maternal cardiac arrest

administer calcium (calcium chloride [10%] 5-10ml or calcium gluconate [10%] 15-30mL IV over 2-5min

Treatment for hypermagnesemia in the pregnant patient?

6 months

Peripartum cardiomyopathy can occur up to HOW LONG after delivery?

left-lateral decubitus

Place the pregnant patient in the WHAT position to relieve possible compression of the inferior vena cava

20th

Preeclampsia/eclampsia develops after the WHAT week of gestation and can produce severe hypertension and ultimate diffuse organ system failure

15min

Survival of the mother has been reported up to HOW LONG after the onset of maternal cardiac arrest with PMCD

5

The best survival rate for the infant occurs when the fetus is delivered no more than WHAT min after the mothers heart stops beating

NO

There is WHAT evidence that shocks from a direct current defibrillator have adverse effects on the heart of the fetus

(1) to use the angled backs of 2 or 3 chairs or (2) to use the angled thighs of several providers

Two methods of supporting the pregnant patient in the left-lateral decubitus position are WHAT and WHAT

maternal survival

WHAT The best hope for fetal survival is

sepsis

WHAT is the leading direct cause of maternal deaths, and the mortality rate is still on the rise

Manual left uterine displacement (LUD)

WHAT is the recommended method that can be used to relieve ACC

Maternal perfusion pressure

WHAT is the sole determinant of uteroplacental and fetal blood flow

Oxytocin

WHAT is used as a uterotonic agent to prevent and treat postpartum hemorrhage

Etomidate or thiopental

WHAT medications are preferred for anesthesia or deep sedation

cardiomyopathy

WHAT, mainly in the form of peripartum WHAT, is a leading cause of pregnancy-related mortality

fibrinolytics

successful use of WHAT for a massive, life threatening pulmonary embolism and ischemic stroke have been reported in pregnant women