SUDDEN MATERNAL COLLAPSE. OBSTETRIC CAUSES CAUSES. Massive obstetric hemorrhage. *Placenta previa. *Abruptio placenta. *PPH. *Uterine rupture. *Supra levator hematoma following genital tract trauma. *Severe pre eclampsia with intra cranial hemorrhage. *Eclampsia. *Amniotic fluid embolism. *Neurogenic shock due to uterine inversion. *Surgical complications. Bleeding after caesarean section. Pelvic /broad ligament hematoma. *Severe sepsis -chorio amnionitis. *Cardiac failure. -peri party cardiomyopathy. MEDICAL //SURGICAL CAUSES Massive pulmonary embolism. Cardiac failure.-pre existing cardiac disease. - Myocardial infarction. Shock -Anaphylactic. -Septic. Intra abdominal bleeding.-hepatic. -spleenic. -aortic rupture Intra cerebral hemorrhage. Metabolic //endocrine -diabetic coma. Over dosage //substance abuse. Cerebral infections. -encephalitis -cerebral malaria. GENERAL INVESTIGATIONS. History. B.P,PR,RR,SP O2,Temperature,urine output. CBP,coagulation profile. Urea and electrolytes. S.uric acid. RBS. Blood group,Rh type and cross match. SPECIFIC INVESTIGATIONS. If a cardiorespiratory cause is suspected ECG. CXR. ABG. If pulmonary embolism 6 suspected Doppler ultrasound of calf veins. Ventilation /perfusion scan V/Q scan. If intracranial pathology is suspected -CT / MRI TREATMENT. Specific treatment depends on the cause. Multidisciplinary approach to optimize outcome. IMMEDIATE MATERNAL RESUSCITATION IS VITAL. "A" AIRWAY. open airway with head tilt and chin lift. "B" BREATHING.Assess for chest movements and breath sounds feel for breathing..If no breathing,put on cardiac arrest call and give rescue breaths. "C" CIRCULATION.Check carotid pulse.optimise circulation by aggressive IV fluids and blood transfusion if needed. CARDIOPULMONARY RESUSCITATION SHOULD BE INITIATED AS NECESSARY. "D" DRUGS To maintain circulation. To combat infections. Anti coagulants in embolism. Anti dotes in drug overdose. "E" ENVIRONMENT. Avoid injury in eclampsia. Ensure safety of the patient and staff. "F" FETUS. If CPR is required , unless there is immediate reversal,immediate caesarean section must be performed If CPR is not required,assess fetal well being and plan delivery as appropriate once maternal condition is stable.