In a pregnant patient who has been given supplemental oxygen, what is the next priority if signs of shock are present?

• A. Position to relieve IVC obstruction.
• B. Treat for shock.
• C. Encourage fluids.
• D. Administer glucose.

Answer: (B)

When signs of shock appear in a pregnant patient who has already received oxygen, the immediate priority is to treat the shock and restore perfusion. Oxygen helps breathing, but shock means the circulating volume and tissue oxygen delivery are critically compromised, so you must act to stabilize circulation right away. That includes rapid assessment and management: ensure a clear airway and continue high-flow oxygen, establish two large-bore IVs, begin rapid isotonic fluid resuscitation as indicated (and address suspected hemorrhage with appropriate fluids and blood products as protocols allow), monitor vital signs, and arrange for rapid transport to a facility equipped for obstetric care. In late pregnancy, placing the patient in a left lateral position can help venous return, but it should not delay active shock treatment. Options like encouraging fluids alone or giving glucose aren’t appropriate as the sole next step when shock is present.