ABSTRACT
Hypovolaemic shock subsequent to antepartum or postpartum haemorrhage is the most common form of shock that midwives will encounter. Sepsis or septic shock has always posed a risk to pregnant and postpartum women, and a recent increase in cases has prompted the development of a new set of assessment tools to aid early recognition and prompt referral. Anaphylaxis is a severe, life-threating, systemic hypersensitivity reaction to a substance to which the woman has become sensitised. The pathophysiology of Amniotic fluid embolism (AFE) is unclear. It seems that amniotic fluid may enter the maternal circulation without causing problems. However, in some women, an inflammatory response can develop, causing a rapid collapse similar to anaphylaxis or septic shock. AFE usually includes a sudden cardiovascular collapse, disseminated intravascular coagulation and hypoxia, often manifesting as an altered mental state or respiratory arrest. In the UK and Ireland, at present AFE is the fifth most common cause of maternal mortality.
