@elsmere_g presents on Maternal Medicine at #Anaesthesia2023. Pregnancy is stressful - it will unmask disease. Pick up the phone. Why are we worried? #OBAnes #OAA23ASM
When looking at @mbrrace reports the UK has shown some improvements in maternal mortality, however, there has been an uptick since 2018. While this is partly accounted for by a changing maternal population (older, more obese, more comorbidities, etc), start inequalities related… twitter.com/i/web/status/1…
Majority are indirect deaths. #OBAnes contributes only a small amount (not to be ignored though). Everyone has a role to play in improving maternity care and reducing mortality & morbidity. Remember majority of deaths occur AFTER delivery - recent pregnancy history shouldn’t be… twitter.com/i/web/status/1…
Common myths in pregnancy. Imaging is not bad, especially when indicated (delayed diagnosis is deadly). Avoid gadolinium, unless required. Resources. Making a (the) diagnosis is essential. Patients CAN decline imaging, but at least allowed adequate informed consent.… twitter.com/i/web/status/1…
Drugs are not necessarily bad, context important. Risk-benefit resource = uktis.org. Stopping anti-epileptics can have significant consequences (get expert advice). Coamoxiclav should be avoided in third trimester. Key message: de-prescribing, balancing choices is… twitter.com/i/web/status/1…
Sick women DO get pregnant. Cancer, renal disease, interstitial lung disease, oh my. Reinforce/ direct contraception and/or pre-pregnancy counselling when you see systemic illness. #Anaesthesia2023 #OBAnes (prelude to #OAA23ASM)
Odd symptoms are NOT due to pregnancy, until proven otherwise. Think heart - older patients, more heart disease. Majority do NOT know they have heart disease. Chest pain is NEVER normal. Pain should be explained, when there’s more call for advice/ look deeper. MEWS are important… twitter.com/i/web/status/1…
NOT everything gets better with delivery. Especially important is preeclampsia - often postnatal presentation of eclampsia or HELLP. @mbrrace has recommendations specific to preeclampsia (in bold). #Anaesthesia2023 #OBAnes (prelude to #OAA23ASM)
Where do we look after the sick parturient (pre/ postnatally)? Depends - pro’s and con’s. May not always be a simple yes/ no answer. Principles of management - MDT MDT MDT. Optimise devastating situations with compassionate care.
#Anaesthesia2023 #OBAnes (prelude to #OAA23ASM)
Networks and MDT’s - knowing WHO to call is important. Important resources with QR codes. #Anaesthesia2023 #OBAnes (prelude to #OAA23ASM)
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