Maternal collapse.
OBJECTIVE
This review will summarize the latest publications on the causes, prevention and treatment of maternal collapse during pregnancy and the postpartum period. It will also explore some future trends particularly in the area of education and team working.


RESULTS
Active management of the third stage of labour has been shown to decrease the incidence of postpartum haemorrhage. Inadequate or prolonged resuscitation following major postpartum haemorrhage can lead to myocardial damage. Guidelines that are followed and the use of drills and simulators may increase effective team working and lead to earlier recognition and treatment of maternal collapse. Some cases of amniotic fluid embolism resemble anaphylaxis and should be treated as such. Important evidence-based guidelines on the management of antithrombolytic prophylaxis and the management of pulmonary embolism have recently been published, which should help clinicians clarify their medical care plans. New resuscitation guidelines in the UK will probably mean that all healthcare workers (including obstetricians and midwives) will need appropriate training every year.


CONCLUSIONS
Understanding the causes of maternal collapse, its early recognition and prompt resuscitation should decrease both maternal and fetal morbidity and mortality. There is increasing evidence that effective preventative measures and improved multidisciplinary team working may have an important impact on maternal and fetal well-being.
Clarke
James
J
Department of Anaesthesia, St George's Hospital, London, UK. clarke@mailbox.co.uk
Butt
Muhammad
M
D004617:Embolism / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D006323:Heart Arrest / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D007743:Labor, Obstetric; D008429:Maternal Welfare; D010353:Patient Education as Topic; D006473:Postpartum Hemorrhage / Q000517:prevention & control / Q000628:therapy; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control / Q000628:therapy; D011256:Pregnancy Outcome; D011655:Pulmonary Embolism / Q000517:prevention & control / Q000628:therapy