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Hypovolaemic shock

G J GJ Hofmeyr and B K BK Mohlala

Best Pract Res Clin Obstet Gynaecol 15(4):18 (2001) PMID 11478820

Measured blood loss up to 1000ml is well tolerated by healthy pregnant women. This is partly due to physiological increases in plasma volume and red cell mass during pregnancy. Nevertheless, hypovolaemic shock is a major cause of maternal mortality. Management requires teamwork, co-ordination, speed and adequate facilities to be life-saving. The first priority is rapid fluid replacement. Evidence from randomized trials has established that crystalloids are the fluids of choice over colloids and particularly albumen, which was associated with increased mortality. Rapid access to blood or blood products for transfusion is necessary, as well as laboratory back-up. Further management includes accurate assessment of the site of bleeding; control of the bleeding; diagnosis and management of the underlying condition; supportive therapy; and monitoring of the clinical, haematological and biochemical response to treatment. Bedside diagnostic ultrasound has several applications in the evaluation of obstetric hypovolaemic shock.

Copyright © 2001 Elsevier Ltd. All rights reserved.

DOI: 10.1053/beog.2001.0205
Version: za2963e q8zaa q8zb4 q8zce q8zd6 q8zec q8zf7 q8zg5

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