The Critical Care Obstetrics Podcast Resuscitative Cesarean Case Review
Dec 22, 2025
A tense case review of a pregnant patient who progressed from respiratory distress to cardiac arrest. They cover missed hypertension, interpreting chest x rays, and diagnosing cardiogenic versus infectious causes. Practical discussion of where to admit high‑risk patients, escalation failures, and the timing and logistics of a resuscitative cesarean. Systems fixes, communication, and training needs are highlighted.
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Perform Timely Fetal Assessment For Admitted Patients
- Do ensure fetal assessment is performed ASAP for admitted pregnant patients and communicate orders clearly.
- Stephanie Martin: this patient had no fetal heart tones documented nor NST despite being 32 weeks and severely hypertensive.
Objective Measures Predict Collapse Better Than Comfort Notes
- Objective bedside measures reveal deterioration that subjective notes miss.
- Respiratory therapist documented 'couldn't do peak flow' yet that was not escalated and the nurse only noted staying to keep patient 'calm and comfortable.'
Treat Anxiety By Fixing Oxygenation Not With Benzodiazepines
- Avoid sedating anxious hypoxemic pregnant patients; address oxygenation and airway first and call anesthesia early.
- Stephanie Martin and Julie Arafeh: staff requested Ativan for agitation instead of assessing respiratory failure and calling anesthesiology to evaluate airway.