Maternal-first stabilization with rapid differentiation of hypertensive, hemorrhagic, thromboembolic, septic, hepatic and cardiac obstetric emergencies.
Maternal resuscitation is the primary driver of fetal survival. Interpret physiology in the pregnancy context (including lower normal PaCO2 and creatinine), assemble obstetric/anesthesia/neonatal expertise early and treat immediately reversible maternal threats.
Use standard ABC resuscitation with early anticipation of a difficult/edematous airway and rapid desaturation. In significant hemodynamic compromise or cardiac arrest at a uterine size consistent with roughly ≥20 weeks, perform manual left uterine displacement to relieve aortocaval compression while maintaining high-quality CPR/resuscitation.
Severe-range hypertension with seizure or end-organ injury requires immediate obstetric escalation, magnesium sulfate and rapid blood-pressure treatment with pregnancy-appropriate IV therapy while evaluating HELLP, stroke, pulmonary edema and other complications.
Activate the local obstetric major-hemorrhage protocol, control the source/uterine cause, give uterotonics when appropriate, use tranexamic acid promptly for diagnosed postpartum hemorrhage within the evidence-based time window, and replace blood components/fibrinogen using clinical, laboratory and/or viscoelastic guidance.
Current cardiovascular critical-illness guidance in pregnancy.
Current postpartum hemorrhage treatment recommendations.
Current adult resuscitation framework used during maternal arrest with pregnancy-specific modifications.
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From confirming true hypoxemia to identifying the underlying mechanism.
From recognizing hypoperfusion and initial crystalloid bolus to dynamic fluid responsiveness assessment and vasopressor targets.
From first-line norepinephrine titration to multi-agent vasopressor escalation and inotrope selection.
From multi-vasopressor failure to rescue non-adrenergic agents and mechanical circulatory support.
Maternal physiology, preeclampsia/eclampsia, HELLP vs AFLP, postpartum hemorrhage (MTP/TXA), peripartum cardiomyopathy, and arrest.
The trauma lethal diamond (hypothermia, acidosis, coagulopathy, hypocalcemia), 1:1:1 massive transfusion (PROPPR trial), early TXA (CRASH-2), and TEG/ROTEM algorithms.
Pulmonary vascular occlusion, acute RV pressure overload, ESC/AHA risk stratification, systemic thrombolysis, catheter-directed therapies, and hemodynamic support.
Life-threatening organ dysfunction caused by a dysregulated host response to infection — recognized by an acute rise in SOFA score, not by infection plus fever alone.
Primary pump failure, SCAI staging (A–E), PAC hemodynamics (CPO, PAPi), inotrope selection, emergent revascularization, and mechanical circulatory support.
Tissue-factor-driven coagulation activation, antithrombin/protein C depletion, PAI-1-associated fibrinolytic suppression, ISTH 2025 DIC assessment, comparison with TTP/HUS/HIT, and targeted replacement.
Hyperammonemia, cytotoxic cerebral edema, balanced coagulopathy, N-acetylcysteine, 3% saline neuroprotection, CRRT ammonia clearance, and King's College transplant criteria.
Multimodal resuscitation, post-cardiac arrest syndrome management, targeted temperature control, and delayed neuroprognostication.
Target organ damage assessment, intravenous antihypertensive titration, and emergency-specific blood pressure targets.
Recognition and time-sensitive escalation of care for prolonged or repeated seizures.