1. From the list, choose the most likely cause of maternal collapse for the scenarios described. Each may be used once, more than once or not at all.

Possible Answers

For each of the questions below, select the answer which is most appropriate. Each option can be used once, more than once or not at all.

a.) A woman with a previous caesarean section is being induced for postdates pregnancy. She had Prostin and ARM and is now on Syntocinon. She has an epidural which is working well. She suddenly has a gush of blood PV, her contractions cease and she collapses in the bed.

Choose from one of the following answersA Amniotic fluid embolismB Cerebrovascular accidentC EpilepsyD EclampsiaE Massive postpartum haemorrhageF Myocardial infarctionG Pulmonary embolusH Uterine inversionI Uterine ruptureJ Vasovagal syncope

b.) A woman (para 5, all normal deliveries) has just delivered her sixth baby. She had a physiological third stage, but traction was required to finally deliver the placenta. She had a moderate loss post delivery of the placenta, approximately 350 mL; the abdomen was palpated and the fundus was not palpable, and assumed to be well contracted. The patient rapidly becomes hypotensive.

Choose from one of the following answersA Amniotic fluid embolismB Cerebrovascular accidentC EpilepsyD EclampsiaE Massive postpartum haemorrhageF Myocardial infarctionG Pulmonary embolusH Uterine inversionI Uterine ruptureJ Vasovagal syncope

c.) A 40-year-old nulliparous woman is 4 hours postnatal. She had pregnancy-induced hypertension at the end of her pregnancy, but laboured spontaneously at 39 weeks. She had 3+ proteinuria in her morning sample and her blood pressure was 150/90 mmHg. She is changing her baby when she collapses and starts to have generalized tonic clonic seizures.

Choose from one of the following answersA Amniotic fluid embolismB Cerebrovascular accidentC EpilepsyD EclampsiaE Massive postpartum haemorrhageF Myocardial infarctionG Pulmonary embolusH Uterine inversionI Uterine ruptureJ Vasovagal syncope

d.) A woman is 5 days post caesarean section in labour. She has a raised BMI of 40. She noticed earlier in the morning that her legs were swollen, but feels that her left leg is larger than her right. She is waiting to be reviewed by the doctors when she collapses.

Choose from one of the following answersA Amniotic fluid embolismB Cerebrovascular accidentC EpilepsyD EclampsiaE Massive postpartum haemorrhageF Myocardial infarctionG Pulmonary embolusH Uterine inversionI Uterine ruptureJ Vasovagal syncope

e.) A multiparous woman has just delivered after a precipitaate labour. She has been under midwifery care in her pregnancy. She starts complaining of feeling short of breath and seconds later collapses. There is no vaginal bleeding and the uterus is well contracted. She is hypoxic and hypotensive and starts to have seizures. The patient is stabilized and consciousness is regained, but subsequently she starts to have bleeding from her Venflon sites.

Choose from one of the following answersA Amniotic fluid embolismB Cerebrovascular accidentC EpilepsyD EclampsiaE Massive postpartum haemorrhageF Myocardial infarctionG Pulmonary embolusH Uterine inversionI Uterine ruptureJ Vasovagal syncope