Kolaps Maternal dan Implikasinya  terhadap Resusitasi Obstetrik

Diana Christine Lalenoh; E. Audrey Christine Herwendro

doi:10.47507/obstetri.v9i2.253

Diana Christine Lalenoh Fakultas Kedokteran Universitas Sam Ratulangi
E. Audrey Christine Herwendro Faculty of Medicine, Sam Ratulangi University–R. D. Kandou General Hospital, Manado, Indonesia

DOI: https://doi.org/10.47507/obstetri.v9i2.253

Keywords: BEAUCHOPPS, kolaps maternal, obstetrik, PMCD, resusitasi jantung paru

Abstract

Kolaps maternal adalah kegawatdaruratan obstetrik kritis yang mengancam nyawa ibu dan janin, mencakup hilangnya kesadaran akut selama kehamilan hingga 6 minggu pascapersalinan. Keberhasilan resusitasi sangat bergantung pada pengenalan dini etiologi dan modifikasi algoritma bantuan hidup dasar maupun lanjut. Tujuan artikel ini mengulas penyebab kolaps maternal dan dampaknya terhadap upaya resusitasi berdasarkan perubahan fisiologis kehamilan. Etiologi kolaps dapat diidentifikasi melalui mnemonik "BEAUCHOPPS", dengan perdarahan, emboli, dan komplikasi anestesi sebagai penyebab utama. Perubahan fisiologis seperti sindrom kompresi aortokaval dan penurunan cadangan oksigen mengharuskan modifikasi resusitasi, termasuk pergeseran uterus ke kiri (left uterine displacement/LUD) dan pertimbangan seksio sesarea perimortem (perimortem cesarean delivery/PMCD) dalam waktu 5 menit. Kesimpulan dari penatalaksanaan kolaps maternal memerlukan pendekatan tim multidisiplin yang terkoordinasi. Pelatihan simulasi berkala dan kepatuhan terhadap protokol berbasis bukti sangat penting untuk meningkatkan angka kelangsungan hidup (survival rate) ibu dan bayi.

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References

Beckett VA, Knight M, Sharpe P. The CAPS Study: incidence, management and outcomes of cardiac arrest in pregnancy in the UK: a prospective, descriptive study. BJOG. 2017;124(9):1374–81. doi:10.1111/1471-0528.14469.

Jeejeebhoy FM, Zelop CM, Lipman S, et al. Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation. 2015;132(18):1747–73. doi:10.1161/CIR.0000000000000300.

Mhyre JM, Tsen LC, Einav S, Kuklina EV, Leffert LR, Bateman BT. Cardiac arrest during hospitalization for delivery in the United States, 1998–2011. Anesthesiology. 2014;120(4):810–18. doi:10.1097/ALN.0000000000000159.

Lipman S, Cohen S, Einav S, Jeejeebhoy F, M Mhyre J, J. Morrison L, et al. The Society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy. Anesth Analg. 2014;118(5):1003–16. doi:10.1213/ANE.0000000000000171.

Kernaghan D, McGrattan K. Maternal collapse. Anaesth Intensive Care Med. 2019;20(7):396–400. doi:10.1016/j.mpaic.2019.04.006.

World Health Organization. Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Geneva: World Health Organization; 2023. Available from: https://www.who.int/publications/i/item/9789240068759.

Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016;27(2):89–94. doi:10.5830/CVJA-2016-021.

Morgan PJ, Cunningham M, Geller S. Maternal collapse: an algorithmic approach to treatment. Curr Anesthesiol Rep. 2019;9:358–66. doi:10.1007/s40140-019-00335-4.

Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, et al. Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):S829–61. doi:10.1161/CIRCULATIONAHA.110.971069.

Panchal AR, Bartos JA, Cabañas JG, Donnino MW, Drennan IR, Hirsch KG, et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142(16 Suppl 2):S366–468. doi:10.1161/CIR.0000000000000916.

Butterworth JF, Mackey DC, Wasnick JD. Obstetric anesthesia. In: Morgan & Mikhail's Clinical Anesthesiology. 7th ed. New York: McGraw-Hill Education; 2022, 847–98.

Gropper MA, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, et al. Obstetric anesthesia. In: Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020, 2328–88.

Dennis AT, Castro JM. Aortocaval compression in the supine pregnant woman: a discussion and review. Aust N Z J Obstet Gynaecol. 2014;54(1):7–10. doi:10.1111/ajo.12114.

LoMauro A, Aliverti A. Respiratory physiology of pregnancy: Physiology masterclass. Breathe. 2015;11(4):297–301. doi:10.1183/20734735.008615.

Wong CA, McCarthy RJ, Fitzgerald PC, Raikoff K, Avram MJ, et al. Gastric emptying of water in obese pregnant women at term. Anesth Analg. 2007;105(3):751–55. doi:10.1213/01.ane.0000267490.07147.4d.

Cunningham FG, Leveno KJ, Dashe JS, Hoffman BL, Spong CY, Casey BM, et al. Maternal physiology. In: Williams Obstetrics. 26th ed. New York: McGraw-Hill Education; 2022, 46–79.

Evensen A, Anderson JM, Fontaine P. Postpartum hemorrhage: prevention and treatment. Am Fam Physician. 2017;95(7):442–49. Tersedia dari: https://www.aafp.org/pubs/afp/issues/2017/0401/p442.html.

Clark SL. Amniotic fluid embolism. Obstet Gynecol. 2014;123(2 Pt 1):337–48. doi:10.1097/AOG.0000000000000107.

Sultan P, Seligman K, Carvalho B. Amniotic fluid embolism: update and review. Curr Opin Anaesthesiol. 2016;29(3):288–96. doi:10.1097/ACO.0000000000000313.

Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing EJ, Harjola EP, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism. Eur Heart J. 2020;41(4):543–603. doi:10.1093/eurheartj/ehz405.

American college of obstetricians and gynecologists. Gestational hypertension and preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):e237–60. doi:10.1097/AOG.0000000000003891.

Davis MB, Arany Z, McNamara DM, Goland S, Elkayam U. Peripartum cardiomyopathy: JACC state-of-the-art review. J Am Coll Cardiol. 2020;75(2):207–21. doi:10.1016/j.jacc.2019.11.014.

Neal JM, Barrington MJ, Fettiplace MR, Gitman M, Memtsoudis SG, Mörwald EE, et al. The Third ASRA Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017. Reg Anesth Pain Med. 2018;43(2):113–23. doi:10.1097/AAP.0000000000000720.

Balki M, Cooke ME, Dunington S, Salman A, Goldszmidt. Unanticipated difficult airway in obstetric patients. Anesth Analg. 2010;110(6):1642–8. doi:10.1213/ANE.0b013e3181d8c7f4.

American Heart Association. Cardiac arrest in pregnancy in-hospital ACLS algorithm [Internet]. Dallas: American Heart Association; 2025 [cited 4th April 2026]. Available from: https://cpr.heart.org/-/media/CPR-Files/CPR-Guidelines-Files/2025-Algorithms/Algorithm-SC-ACLS-CA-in-Pregnancy-250620.pdf