Académique Documents
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Studies
Patricia M. Witcher, RNC-OB, MSN
Northside Hospital
Labor and Delivery, High Risk Obstetrics
Atlanta, Georgia
Maternal Mortality Rates in the
U.S. 1979 to 2005
16
9.6
6.4
1979 3.2
1981
1983
1965
1987
1989
1991
1993
1995 0
1997
1999
2001
2003
2005
25
20
Mortality %
15
10
0 Hemorrhage Thrombotic PE AFE Infection Hypertension Cardiomyopathy Anesthesia CVA CV Conditions Non CV Medical
!CO
Placental
vasoconstriction
! uteroplacental !PaO2
perfusion "PaCO2
FHR abnormality
Hemodynamic
Stabilization
• Assess according to normal hemodynamic values for
pregnancy
• Ensure adequate circulating blood volume whenever
possible to maintain uteroplacental perfusion
– Lateral positioning
– Judicious afterload reduction
– “Gental” diuresis in the setting of fluid overload
Determinant of Fetal Oxygenation
• Uteroplacental perfusion
• Greatly determined by maternal cardiac
output and circulating blood volume