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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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My Heart is Racing! Select Cardiac Arrhythmias and Practice Updates

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sábado, 28 de mayo de 2016

Medical emergencies in pregnancy

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EMOttawa - May 26, 2016 - By Lauren Lacroix
"The pregnant or postpartum patient presents a unique set of challenges to the emergency physician. Although life-threatening emergencies are relatively rare, they require specialized protocols and different considerations than we’re used to (i.e. medications contraindicated in pregnancy and lactation). Maternal morbidity is increasing as women are seeking pregnancy at a later age – 1 in 12 births in the US in 2008 was to women greater than 35 years of age compared to 1 in 100 in 1970. According to the Public Health Agency of Canada, there were 6 deaths per 100 000 deliveries in 2011. The most common diagnosis associated with these deaths were diseases of the circulatory system. Finally, pregnancy-related emergencies can carry significant emotional distress, as there are two patients to consider.
Take Home Points 
  • Normal pregnancy causes significant physiologic changes. 
  • 70% of all PE's in pregnancy occur postpartum and the risk of PE increases with each trimester. 
  • Work up is unlikely to cause significant fetal radiation exposure, use a shared decision-making model.
  • Pregnancy increases the risk of MI 3-4 times, consider SCAD on the DDx. 
  • Consider cardiomyopathy in late pregnancy and puerperium. 
  • ZIKV test and counselling is available in Canada."