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FOCUSED SHIFT VIEW

Pregnancy-Related Emergency

Pregnancy status changes the differential, imaging, medications, destination, and team.

Open full pathway
Educational first-pass aid. Reassess the patient, confirm doses and use local protocols.

1 · First minutes

  1. Confirm pregnancy status and gestational/postpartum age without delaying resuscitation.
  2. Prioritize hemorrhage, ectopic pregnancy, severe hypertension/eclampsia, thromboembolism, sepsis, trauma, and cardiopulmonary disease.
  3. Use obstetric, anesthesia, neonatal, and transfer resources early; local destination protocols matter.

2 · Escalate now if

  • Hypotension, syncope, severe abdominal pain, shoulder pain, or heavy bleeding
  • Severe hypertension, seizure, headache/visual change, RUQ pain
  • Dyspnea, hypoxia, chest pain, syncope, or unilateral leg swelling
  • Trauma, decreased fetal movement, fluid loss, or painful contractions
  • Postpartum symptoms—risk persists after delivery

3 · Immediate workup

  • Pregnancy test, CBC/type and screen, focused ultrasound when available, ECG/glucose as indicated
  • Rh status and obstetric hemorrhage protocol according to local practice

4 · Don’t miss

  • Ruptured ectopic pregnancy
    Pain/bleeding with positive pregnancy test and instability is a surgical emergency.
  • Severe preeclampsia / eclampsia
    Severe hypertension, headache, visual symptoms, RUQ pain, dyspnea, seizure, or postpartum presentation needs immediate obstetric protocol.
  • Obstetric hemorrhage / placental abruption
    Bleeding, pain, uterine tenderness, shock, or trauma requires resuscitation and obstetric escalation.
  • Pulmonary embolism / peripartum cardiomyopathy
    Dyspnea, chest symptoms, syncope, hypoxia, or new heart-failure signs require urgent evaluation.

5 · Disposition lane

Admit / obstetric unit

Bleeding, hypertension, infection, hyperemesis with derangement, trauma, or uncertain maternal/fetal status.

Resuscitation / OR / transfer

Ectopic rupture, eclampsia, major hemorrhage, severe cardiopulmonary illness, or need for higher-level obstetric care.