Underlying medical conditions

Area of Science:

• Obstetrics and Gynecology
• Internal Medicine
• Critical Care Medicine

Background:

• Over 50% of maternal deaths in the UK stem from pre-existing medical conditions.
• Acute medical emergencies can present with symptoms similar to obstetric emergencies, complicating diagnosis and management.
• Rare medical conditions can be overlooked in pregnant women, potentially leading to adverse outcomes.

Purpose of the Study:

• To highlight uncommon acute medical conditions that can occur during pregnancy.
• To emphasize the importance of considering these conditions in the differential diagnosis of obstetric emergencies.
• To guide obstetricians on the initial emergency management steps for these rare medical cases.

Main Methods:

• Review of literature on acute medical conditions presenting during pregnancy.
• Analysis of case presentations where medical conditions mimicked obstetric emergencies.
• Discussion of diagnostic challenges and initial management strategies.

Main Results:

• Systemic lupus erythematosus flares, thyroid storms, and phaeochromocytomas can mimic eclampsia.
• Postpartum hemorrhage can be confused with Addison's syndrome or acute renal failure.
• Pulmonary embolism, myocardial infarction, tachyarrhythmia, and myasthenia gravis can cause acute collapse.

Conclusions:

• Acute medical conditions are an under-recognized cause of maternal morbidity and mortality.
• A high index of suspicion and inclusion in differential diagnoses are vital for timely identification.
• Obstetricians require knowledge of initial emergency management for these rare but serious conditions.