Click to enlarge Amiodarone is a pregnancy category D drug, where there is known risk to the fetus with administration to the mother. Amiodarone causes thyroid problems, arrhythmia, and growth retardation to the baby, and is therefore relatively contra-indicated in pregnant patients. Several sources suggest Lidocaine be given between 24-42 weeks gestation as an alternative, particularly when bearing in mind that Amiodarone has a very long half life (up to 40 days.) Amiodarone is safe to be given postpartum.
Other ACLS drugs are generally safe for pregnant women.
Other simple modifications may include positioning of the pregnant patient in need of CPR at an angle (with a wedge pillow, for example) to avoid fetal pressure on the vena cava (and therefore decreasing blood return to the heart) and to very quickly search for possible reversible causes of arrest. Some of these factors are embodied in the mneumonics A CUB HOPES or BEAU CHOPS.
•A-nesthesia
•C-ardiac disease
•U-terine atony
•B-leeding
•H-ypertension
•O-ther
•P-lacenta
•E-mbolism
•S-epsis
..........................................
•B-leeding/DIC
•E-mbolism: coronary/pulmonary/amniotic fluid
•A-nesthesia- complications
•U-terine atony
•C-ardiac disease- MI. cardiomyopathy/ischemia/aortic
•H-ypertension- preeclampsia/eclampsia
•O-ther: usual differential diagnosis
•P-lacenta: abruption/previa
•S-epsis
Other ACLS drugs are generally safe for pregnant women.
Other simple modifications may include positioning of the pregnant patient in need of CPR at an angle (with a wedge pillow, for example) to avoid fetal pressure on the vena cava (and therefore decreasing blood return to the heart) and to very quickly search for possible reversible causes of arrest. Some of these factors are embodied in the mneumonics A CUB HOPES or BEAU CHOPS.
•A-nesthesia
•C-ardiac disease
•U-terine atony
•B-leeding
•H-ypertension
•O-ther
•P-lacenta
•E-mbolism
•S-epsis
..........................................
•B-leeding/DIC
•E-mbolism: coronary/pulmonary/amniotic fluid
•A-nesthesia- complications
•U-terine atony
•C-ardiac disease- MI. cardiomyopathy/ischemia/aortic
•H-ypertension- preeclampsia/eclampsia
•O-ther: usual differential diagnosis
•P-lacenta: abruption/previa
•S-epsis
