see [[Pregnant trauma]], [[Airway#Pregnant Airway]], [[Peri-intubation collapse#pregnancy intubation]], [[Ob-Gyn#Bad things that pregnancy increases risk for|Pregnancy risks]] - [Dunn normal pregnancy](x-devonthink-item://D877748C-19AD-4286-8D2F-01C7B05ED496) - [Rosen Complications of pregnancy](x-devonthink-item://2EDF4F0B-04B3-4DB8-A54E-A5775713FD62) - [Rosen Medical emergencies during pregnancy](x-devonthink-item://07AC335F-A2F0-4AEE-816F-4A674AC53E80) - [Rosen trauma in pregnancy](x-devonthink-item://C57F7072-104E-4982-B03E-BB1A04F7C060) - [Rosen Drug therapy in pregnancy](x-devonthink-item://5542BB90-2454-4451-AC15-8D92E4370C0E) - [Pregnancy Complicated by Valvular Heart Disease - 2014](bookends://sonnysoftware.com/ref/DL/162353) - [online](https://www.ahajournals.org/doi/10.1161/JAHA.113.000712) #cram **Cardiovascular** - blood volume increases --> ==may loose 1/3 of volume before signs of haemorrhagic shock appear== - maternal cardiac output increases - resting heartrate increase 15-20 BPM - IVC compression from gravid uterus > the increase in cardiac output and heart rate and decrease in resting blood pressure can mask signs of hypovolaemia **Haematological** - blood volume increases by 1500mL during pregnancy , 1000mL of which is plasma; therefore, there is a relative dilutional anaemia - leukocytosis - increase in coagulation factors --> increase risk of [[Pulmonary Embolism|blood clots]] - placental abruption can precipitate [[DIC]] > given immaturity of immune system of foetus when pregnant women require blood transfusion, specialised RBC products usually needed (eg CMV negative products) **Respiratory** - increase in airway oedema - diaphragm elevated - tidal volume and minute respiriation increase - 20% reduction in FRC can lead to a VQ mismatch and decrease O2 reserves in compromised patient > these changes predispose pregnant patient to rapid O2 desaturation an increased tidal volume and resp rate lead ot increased minute volume and **decreased PaCo2**; *therefore a pregant patient with resp failure may have a **normal** CO2* **Gastrointestinal** - gastric emptying is slowed in pregnancy, increase risk of aspiration - GORD, increased risk of aspiration > assume a full stomach in all pregnant patients ; insert NG tube in those with altered conscous state or intubated **Urinary** - bladder displaced into abdomen --> ==more sensitive to trauma== - glycosuria common in pregnancy - mild hydronephrosis occurs in late pregnancy **Uterine** - massive increase in uterine size and increase blood flow to uterus > increases potential for massive blood loss from traumatised uterus or pelvis ![[Pasted image 20231117181756.png]] ![[Pasted image 20241110165431.png]]