By Michael A. Belfort, George R. Saade, Michael R. Foley, Jeffrey P. Phelan, Gary A. Dildy III
Serious Care Obstetrics presents specialist scientific information all through on how one can maximize the probabilities of your sufferer and her child surviving trauma.In this stimulating textual content, the world over well-known specialists consultant you thru the main hard events you as an obstetrician tend to face, permitting you to skillfully:Recognize stipulations early-on which would turn out lifestyles threateningImplement speedy life-saving remedies in emergency situationsMaximize the survival clients of either the mummy and her fetusThe 5th version of this well known publication might help you retain your composure in excessive danger medical events, making it a useful source for any health care professional accountable for the care and administration of pregnant girls and their unborn youngsters.
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Additional info for Critical Care Obstetrics, 5th Edition
Her obstetric history was significant for an unplanned pregnancy which occurred approximately 1 year following her CABG and MI. She decided to undergo termination of the pregnancy after consultation with a cardiologist and perinatologist. Less than a year later, she presented at 9 weeks estimated fetal gestational age (EGA) for consultation with a perinatologist. She was subsequently referred to a perinatologist at a local tertiary care center. Initial evaluation included an echocardiogram which indicated persistent moderate to severe left ventricular dysfunction, an ejection fraction between 25 and 30%, and elevated pulmonary artery pressures.
However, correlation is poor in patients with low or high cardiac output 18 states . 0 L/min. 0 L/min during an acute or critical illness. Such high cardiac outputs are also expected during labor, birth, and immediately postpartum. It is also imperative that cardiac output assessment be performed between uterine contractions. A number of physiologic events occur during uterine contractions, including autotransfusion of blood from the uterus into the maternal central circulation, which in turn produces significant alteration in cardiac output.
Any reduction in maternal PaO2 thus decreases uterine venous PO2 and umbilical venous PO2. Uterine contractions cause a reduction in uterine blood flow secondary to a significant increase in uterine vascular resistance. In addition to the effect of uterine contractions, a number of maternal conditions may impair oxygen delivery. In essence, any condition that causes maternal uterine venous PO2 to be reduced will also result in decreased oxygen transport to the fetus. For these reasons, it is especially important for the nurse to frequently assess the hemodynamic and oxygen transport status of the obstetric patient requiring mechanical ventilation.