General Approach to the Pregnant Patient

Morrison, Laurie J.; Toma, Alina; Gray, Sara

doi:10.1016/b978-0-323-05472-0.00175-4

Cited by 3 publications

(7 citation statements)

References 77 publications

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“…The heart rate typically increases throughout pregnancy and by the end of the third trimester the heart rate is 10–20 beats per min more than in the nonpregnant state. [ 1 3 5 – 7 ] Progesterone-induced smooth muscle relaxation results in decreased vascular resistance, which leads to a fall in systolic blood pressure by 2–3 mm Hg and in diastolic blood pressure by 10–15 mm Hg during the first two trimesters; the blood pressure returns to prepartum values during the third trimester. [ 1 4 5 ] There is also a 5 mm Hg decrease in central venous pressure by the third trimester.…”

Section: Anatomy and Physiology Of Pregnancymentioning

confidence: 99%

“…Additionally, pregnant patients have a dilutional anemia due to a 50% increase in plasma volume accompanied by a 30% increase in red blood cell mass. [ 1 3 4 9 ] At term, the placenta alone receives 10% of the maternal circulating blood volume. The increase in circulating volume means that a great amount of hemorrhage can take place before signs of maternal hypovolemia become apparent.…”

Section: Anatomy and Physiology Of Pregnancymentioning

confidence: 99%

“…By 20 weeks' gestation the gravid uterus has reached the level of the inferior vena cava and in the supine position can cause vena caval compression and a resultant hypotension. [ 2 3 5 9 10 ] This can cause the supine hypotensive syndrome that is seen in approximately 10% of pregnant patients. This syndrome is characterized by syncope, hypotension, and bradycardia.…”

Section: Anatomy and Physiology Of Pregnancymentioning

confidence: 99%

“…Changes in maternal anatomy and physiology during pregnancy can affect both the incidence of certain diseases as well as the mother's ability to adapt to illness. [ 3 ] Trauma, pulmonary embolism, hemorrhage, hypertension, and infection are the leading causes of maternal death in pregnancy. [ 2 3 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 3 ] Trauma, pulmonary embolism, hemorrhage, hypertension, and infection are the leading causes of maternal death in pregnancy. [ 2 3 ]…”

Section: Introductionmentioning

confidence: 99%

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Cardiac arrest and pregnancy

Campbell

Sanson

2009

J Emerg Trauma Shock

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Cardiopulmonary arrest in pregnancy is rare occurring in 1 in 30,000 pregnancies. When it does occur, it is important for a clinician to be familiar with the features peculiar to the pregnant state. Knowledge of the anatomic and physiologic changes of pregnancy is helpful in the treatment and diagnosis. Although the main focus should be on the mother, it should not be forgotten that there is another potential life at stake. Resuscitation of the mother is performed in the same manner as in any other patient, except for a few minor adjustments because of the changes of pregnancy. The specialties of obstetrics and neonatology should be involved early in the process to ensure appropriate treatment of both mother and the newborn. This article will explore the changes that occur in pregnancy and their impact on treatment. The common causes of maternal cardiac arrest will be discussed briefly.

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Section: Anatomy and Physiology Of Pregnancymentioning

confidence: 99%

Section: Anatomy and Physiology Of Pregnancymentioning

confidence: 99%

Section: Anatomy and Physiology Of Pregnancymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…[ 3 ] Trauma, pulmonary embolism, hemorrhage, hypertension, and infection are the leading causes of maternal death in pregnancy. [ 2 3 ]…”

Section: Introductionmentioning

confidence: 99%

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Cardiac arrest and pregnancy

Campbell

Sanson

2009

J Emerg Trauma Shock

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Pregnancy Disasters in the First Trimester

Scherer

Zappolo

2017

Physician Assistant Clinics

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Is Routine Pregnancy Testing Necessary in Women with Suspected UTI?

Stein¹

2011

TOEMJ

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Abstract:Objective: To determine if women of reproductive age who present to the Emergency Department (ED) with urinary tract infection (UTI) symptoms can accurately predict their pregnancy status. Methods:We performed a retrospective study of women who presented to the ED with UTI symptoms (dysuria, frequency, or urgency). Consecutive females aged 18-49 years were referred from triage to a computer kiosk in the waiting room. The kiosk asked all patients in oral and written format: "Are you pregnant, worried you might be pregnant or have you missed your last period?" Patient responses about pregnancy risk were compared to urine pregnancy test results. Test characteristics and post-test probabilities were calculated.Results: From a total of 300 eligible subjects, 216 received a pregnancy test, of which 10 were positive, giving a pregnancy prevalence of 5%. Of 196 patients who reported no pregnancy risk, 4 were found to be pregnant, yielding a negative posttest probability of pregnancy = 2.0% (95%CI 0.8-5.1). Among the 155 women diagnosed with a UTI, 6 were pregnant, giving a prevalence of 4%. Of the 144 patients who reported no pregnancy risk, 2 were found to be pregnant, yielding a negative posttest probability of 1.4% (95% CI 0.4-4.9).Conclusions: Adult women presenting to the ED with UTI symptoms who report no pregnancy risk have a 2% or lower probability of actually being pregnant. We believe this level of accuracy to be sufficient for routine clinical practice, and consider it is reasonable to initiate empiric antibiotic therapy without diagnostic pregnancy testing in such patients.

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General Approach to the Pregnant Patient

Cited by 3 publications

References 77 publications

Cardiac arrest and pregnancy

Cardiac arrest and pregnancy

Pregnancy Disasters in the First Trimester

Is Routine Pregnancy Testing Necessary in Women with Suspected UTI?

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