Sudden Obstetric Collapse

Abstract

Pregnant women are generally considered to be a “low-risk” population, and a typical labor and delivery suite is not designed to manage a woman that may experience a collapse. However, even a “low-risk” pregnancy carries life-threatening risks. In 2010, worldwide maternal deaths were studied and over 50 % of the deaths occurred in six countries with the highest number occurring in India (Trends in Maternal Mortality 1990 to 2013. The World Bank and United Nation population division: trends in maternal mortality: 1990 to 2013. Geneva: WHO, 2014). It is not uncommon for a pregnant woman to be brought into a hospital in a collapsed condition. When the cause of maternal collapse is not known, there is too often a delay in diagnosis and treatment. This delay is associated with increased risk of maternal morbidity and mortality. One way to reduce the maternal morbidity and mortality of sudden maternal collapse is by prevention of the common antecedents to this condition. Recognition of the subset of patients at highest risk is imperative. Anticipation, early diagnosis, and rapid response are the three critical factors in preventing maternal deaths.

Formation of a rapid response team is another crucial step. The two most important aspects of rapid response team development are team building and regular drills. At every hospital that provides care for the pregnant woman, a system should be in place for the rapid response team. For the system to work, optimally trained individuals are identified with specific duties assigned to each team member to handle the emergencies efficiently and rapidly. Regular drills are important in providing timely and well-coordinated care and preventing confusion among the members of the rapid response team.