From Columbia U: Critical care in pregnancy-Is it different?

Semin Perinatol. 2014 Aug 28. pii: S0146-0005(14)00075-5. doi: 10.1053/j.semperi.2014.07.002. [Epub ahead of print]

Critical care in pregnancy-Is it different?

Gaffney A.

Author information

• Department of Anesthesiology, Columbia University Medical Center, 622 W 168th St PH5-505, New York, NY 10032. Electronic address: ag2606@cumc.columbia.edu.

Abstract

In the first part of this review, the epidemiology of obstetric critical care is discussed. This includes the incidence of severe morbidity in pregnancy, identification of critically ill and potentially critically ill patients, the incidence of obstetric ICU admissions, the type of critical illness by stage of pregnancy, ICU admission diagnoses, the severity of illness in obstetric ICU patients compared to non-obstetric patients, ICU mortality of obstetric patients, the ICU proportion of total maternal mortality, and the causes of death for obstetric patients in ICU. In the second part, the management of obstetric patients who happen to be admitted to a general ICU is discussed. Rather than focusing on the management of particular obstetric conditions, general principles of ICU management will be discussed as applied to obstetric ICU patients. These include drug safety, monitoring the fetus, management of the airway, sedation, muscle relaxation, ventilation, cardiovascular support, thromboprophylaxis, and radiology and ethicalissues.