Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about cardiac arrest in pregnancy.

And you can find written notes on this topic at zero to finals.com slash cardiac arrest or in the antinatal care section of the Zero to finals, obstetrics and gynecology book.

So let's get straight into it.

There are differences between cardiac arrest and resuscitation in pregnancy compared with standard adult resuscitation.

Always follow the local and national guidelines,

get formal training and involve experienced seniors

when you're managing critically ill patients.

The relevant RCOG guidelines on maternal collapse are from 2011.

This overview is here to help you understand the concepts in preparation for your

exams and not manage patients. Let's talk about the causes of cardiac arrest in pregnancy.

The Resuscitation Council UK lists the reversible causes of adult cardiac arrest as the four T's and the four H's.

It's worth committing these to memory. The four T's are thrombosis, for example, a PE or a myocard

lymphaction or heart attack, a tension pneumothorax, toxins and tamponard, meaning cardiac tamponard.

The four Hs are hypoxia, hypovolemia, hypothermia, hypothermia,

and the final H is hypercilemia, hypoglycemia and other metabolic abnormalities.

The RCOG guideline advises adding to the list for pregnant women, eclampsia and intracranial hemorrhage.

The three major causes of cardiac rest in pregnancy that's worth remembering

are obstetric hemorrhage, pulmonary embolism and sepsis leading to metabolic acidosis and

septic shock. Obstetric hemorrhage is a major cause of severe hypovalemia with lots of blood loss resulting in cardiac arrest.

Remember the causes of massive obstetric hemorrhage, which are ectopic pregnancy, which occurs in early pregnancy,

placental abruption, including a concealed hemorrhage where there's minimal

vaginal bleeding because all the bleeding is within the uterus, placenta previa, placenta

...