Abstract
Objective The recommendations of the Shock Section of the German Interdisciplinary Association
for Intensive and Emergency Medicine (DIVI) and the Maternal Disorders Section of
the Working Group on Obstetrics and Prenatal Medicine (AGG) aim to improve the diagnosis
and management of pregnant patients in shock. In 2018, the DIVI Shock Section published
a revised classification of shock types. Given that pregnancy involves extensive physiological
changes affecting all organ systems – with direct implications for the development
and progression of shock – specific characteristics of shock in pregnancy were analyzed.
Methods A selective literature review and iterative consensus process were conducted within
the DIVI Shock Section and the Maternal Disorders Section of the AGG.
Results Shock, defined as a state of circulatory failure characterized by a critical mismatch
between oxygen delivery (DO2 ) and consumption (VO2 ), is common to all shock types, including in pregnant women. Unique features of pregnancy
include altered sensitivity to triggering factors, modified classical shock symptoms,
and specific diagnostic and therapeutic approaches to optimize outcomes for both mother
and child.
Conclusions The statements and recommendations facilitate the identification of underlying causes
across the different forms of shock (hypovolemic, distributive, cardiogenic, and obstructive)
and support the initiation of appropriate management strategies.
Keywords pregnancy - shock - emergency medicine - obstetrics - intensive care medicine
