Collapse as it presents to the obstetrician can be due to a variety of causes, including innocent vasovagal faint through to cardiac arrest, but the initial assessment and management of the patient is remarkably similar and requires a systematic disciplined ABC approach (airway, breathing, circulation) combined with lateral tilting of the pregnant patient to minimize aortocaval compression. The essential steps of how to approach the apparently lifeless patient are summarized in Fig. 18.1 and aim to make the crucial diagnosis of cardiac arrest (as opposed to reduced consciousness due to another cause) so that cardiopulmonary resuscitation can be commenced early. Most other conditions require basic resuscitation with attention to the airway and breathing combined with intravenous access and circulatory support while the cause of the problem is diagnosed and then treated (Table 18.1).
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.