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Chapter 72 - Critical Care in Obstetrics (Content last reviewed: 15th December 2018)

from Section 7 - Postnatal Problems

Published online by Cambridge University Press:  15 November 2017

By
Soha A. Tohamy Said
Edited by
David James ,
Philip Steer ,
Carl Weiner ,
Bernard Gonik  and
Stephen Robson
David James
Affiliation:
University of Nottingham
Philip Steer
Affiliation:
Imperial College London
Carl Weiner
Affiliation:
University of Kansas
Bernard Gonik
Affiliation:
Wayne State University, Detroit
Stephen Robson
Affiliation:
University of Newcastle
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Summary

In principle, the obstetric patient can have any surgical or medical condition that would necessitate ICU admission in a nonpregnant woman. However, the majority of obstetric critical care admissions are for a number of pregnancy-specific conditions.

Type
Chapter
Information
High-Risk Pregnancy
Management Options
 , pp. 2014 - 2066
Publisher: Cambridge University Press
First published in: 2017

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References

Maternal Critical Care Working Group. Providing Equity of Critical and Maternity Care for the Critically Ill Pregnant or Recently Pregnant Woman. London: Royal College of Anaesthetists, 2011. http://www.rcoa.ac.uk/system/files/CSQ-ProvEqMatCritCare.pdf (accessed March 2017).Google Scholar
Pollock, W, Rose, L, Dennis, CL. Pregnant and postpartum admissions to the intensive care unit: a systematic review. Intensive Care Med 2010; 36: 1465–74.Google Scholar
Intensive Care Society. Levels of Critical Care for Adult Patients. London: ICS, 2009. http://www.ics.ac.uk/ICS/guidelines-and-standards.aspx (accessed March 2017).Google Scholar
Royal College of Obstetricians and Gynaecologists. Maternal Collapse in Pregnancy and the Puerperium. Green-top Guideline No. 56. London: RCOG, 2011. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg56 (accessed March 2017).Google Scholar
Vasdev, GM, Harrison, BA, Keegan, MT, Burkle, CM. Management of the difficult and failed airway in obstetric anesthesia. J Anesth 2008; 22(1): 38–48. PMID 18306012.Google Scholar
Fujitani, S, Baldisseri, MR. Hemodynamic assessment in a pregnant and peripartum patient. Crit Care Med 2005; 33 (10 Suppl): S354–61. PMID 16215359.Google Scholar
Royal College of Obstetricians and Gynaecologists. Severe Pre-eclampsia/Eclampsia: Management. Green-top Guideline No. 10A. London: RCOG, 2006. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg10a (accessed March 2017).Google Scholar
Saravanakumar, K, Davies, L, Lewis, M, Cooper, GM. High dependency care in an obstetric setting in the UK. Anaesthesia, 2008; 63: 1081–6.Google Scholar
Royal College of Obstetricians and Gynaecologists. Improving Patient Handover. Good Practice No. 12. London: RCOG, 2010. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/good-practice-12/ (accessed March 2017).Google Scholar
Cantwell, R, Clutton-Brock, T, Cooper, G, et al. Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer: 2006–2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG 2011; 118 (Suppl 1): 1–203.Google Scholar
Intensive Care Society. Guidelines for the Transport of the Critically Ill Adult, 3rd edn. London: ICS, 2011. http://www.ics.ac.uk/ICS/guidelines-and-standards.aspx (accessed March 2017).Google Scholar
Institute for Healthcare Improvement. Early Warning Systems: Scorecards That Save Lives. http://www.ihi.org/resources/pages/improvementstories/earlywarningsystemsscorecardsthatsavelives.aspx (accessed March 2017).Google Scholar
Institute for Healthcare Improvement. SBAR: Situation, Background, Assessment, Recommendation. http://www.ihi.org/resources/Pages/Tools/sbartoolkit.aspx (accessed March 2017).Google Scholar
Resuscitation Council (UK). Resuscitation Guidelines 2015. https://www.resus.org.uk/resuscitation-guidelines (accessed March 2017).Google Scholar
Royal College of Obstetricians and Gynaecologists. Antenatal Corticosteroids to Reduce Neonatal Morbidity and Mortality. Green-top guideline No.7. London: RCOG, 2010. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg7 (accessed March 2017).Google Scholar
National Institute for Health and Care Excellence. Postnatal Care up to 8 Weeks after Birth. NICE Clinical Guideline CG37. London: NICE, 2006. https://www.nice.org.uk/guidance/cg37 (accessed March 2017).Google Scholar
Santillan, M, Yankowitz, J. Fetal effects of drugs commonly used in critical care. In Belfort, MA, Saade, GR, Foley, MR, Phelan, JP, Dildy, GA (eds), Critical Care Obstetrics, 5th edn. Oxford: Wiley-Blackwell; 2010, pp. 626–38.Google Scholar
Cartin-Ceba, R, Gajic, O, Iyer, VN, Vlahakis, NE. Fetal outcomes of critically ill pregnant women admitted to the intensive care unit for non obstetric causes. Crit Care Med 2008; 36: 2746–51. PMID 18828192.Google Scholar
ACOG Committee on Obstetric Practice. ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy. Obstet Gynecol 2004; 104: 647–51. PMID 15339791.Google Scholar
Jubran, A. Pulse oximetry. Intensive Care Med 2004; 30: 2017–20. PMID 15278272.Google Scholar
Ortega, R, Hansen, CJ, Elterman, K, Woo, A. Videos in clinical medicine. Pulse oximetry. N Engl J Med 2011; 364 (16): e33. PMID 21506738.Google Scholar
Krauss, B, Silvestri, S, Falk, JL. Carbon dioxide monitoring (capnography). UpToDate 2016. http://www.uptodate.com/contents/carbon-dioxide-monitoring-capnography (accessed March 2017).Google Scholar
Intensive Care Society. Capnography in the Critically Ill. London: ICS, 2009. http://www.ics.ac.uk/ICS/guidelines-and-standards.aspx (accessed March 2017).Google Scholar
Vincent, JL, Rhodes, A, Perel, A, et al. Clinical review: update on hemodynamic monitoring: a consensus of 16. Crit Care 2011; 15: 229. PMID 21884645.Google Scholar
Paruthi, S, Rosen, CL, Wang, R, et al. End-tidal carbon dioxide measurement during pediatric polysomnography: signal quality, association with apnea severity, and prediction of neurobehavioral outcomes. Sleep 2015; 38: 1719–26.Google Scholar
Pishbin, E, Ahmadi, GD, Sharifi, MD, et al. The correlation between end-tidal carbon dioxide and arterial blood gas parameters in patients evaluated for metabolic acid-base disorders. Electron Physician 2015; 7: 1095–10.Google Scholar
Pearce, AK, Davis, DP, Minokadeh, A, Sell, RE. Initial end-tidal carbon dioxide as a prognostic indicator for inpatient PEA arrest. Resuscitation 2015; 92: 77–81.Google Scholar
Belfort, MA, Rokey, R, Saade, GR, Moise, KJ. Rapid echocardiographic assessment of left and right heart hemodynamics in critically ill obstetric patients. Am J Obstet Gynecol 1994; 171: 884–92.Google Scholar
Dennis, AT. Transthoracic echocardiography in obstetric anaesthesia and obstetric critical illness. Int J Obstet Anesth 2011; 20: 160–8. PMID 21315578.Google Scholar
Expert Round Table on Ultrasound in ICU. International expert statement on training standards for critical care ultrasonography. Intensive Care Med 2011; 37: 1077–83. PMID 21614639.Google Scholar
Cholley, B, Vieillard-Baron, A, Mebazaa, A. Echocardiography in the ICU: time for widespread use! Intensive Care Med 2006; 32: 9–10. PMID 16292627.Google Scholar
Clark, SL, Southwick, J, Pivarnik, JM, et al. A comparison of cardiac index in normal term pregnancy using thoracic electrical bio-impedance and oxygen extraction (Fick) techniques. Obstet Gynecol 1994; 83: 669–72.Google Scholar
Theodore, AC. Venous blood gases and other alternatives to arterial blood. UpToDate 2016. http://www.uptodate.com/contents/venous-blood-gases-and-other-alternatives-to-arterial-blood-gases (accessed March 2017).Google Scholar
Awasthi, S, Rani, R, Malviya, D. Peripheral venous blood gas analysis: an alternative to arterial blood gas analysis for initial assessment and resuscitation in emergency and intensive care unit patients. Anesth Essays Res 2013; 7: 355–8.Google Scholar
Bakker, J, Nijsten, MW, Jansen, TC. Clinical use of lactate monitoring in critically ill patients. Ann Intensive Care 2013; 3: 12.Google Scholar
Nichol, AD, Egi, M, Pettilä, V, Bellomo, R, French, C, Hart, G, et al. Relative hyperlactatemia and hospital mortality in critically ill patients: a retrospective multi-centre study. Crit Care 2010; 14: R25. PMID 20181242.CrossRefGoogle ScholarPubMed
Wacharasint, P, Nakada, TA, Boyd, JH, Russell, JA, Walley, KR. Normal-range blood lactate concentration in septic shock is prognostic and predictive. Shock 2012; 38: 4–10. PMID 22552014.Google Scholar
Zhang, X, Xuan, W, Yin, P, et al. Gastric tonometry guided therapy in critical care patients: a systematic review and meta-analysis. Crit Care 2015; 19: 22.Google Scholar
Arora, S, Singh, PM, Goudra, BG, Sinha, AC. Changing trends of hemodynamic monitoring in ICU: from invasive to non-invasive methods: are we there yet? Int J Crit Illn Inj Sci 2014; 4: 168–77.Google Scholar
Ramsingh, D, Alexander, B, Cannesson, M. Clinical review: does it matter which hemodynamic monitoring system is used? Critical Care 2012, 17: 208.Google Scholar
Koyfman, A, Rowe, VL. Arterial line placement. Medscape 2015. http://emedicine.medscape.com/article/1999586-overview (accessed March 2017).Google Scholar
Hadian, M, Pinsky, MR. Evidence-based review of the use of the pulmonary artery catheter: impact data and complications. Crit Care 2006; 10 (Suppl 3): S8.Google Scholar
Phillips, RA, Hood, SG, Jacobson, BM, et al. Pulmonary artery catheter (PAC) accuracy and efficacy compared with flow probe and transcutaneous Doppler (USCOM): an ovine cardiac output validation. Crit Care Res Pract 2012; 2012: 621496.Google ScholarPubMed
Garpestad, E, Brennan, J, Hill, NS. Noninvasive ventilation for critical care. Chest 2007; 132: 711–20.Google Scholar
SooHoo, GW. Noninvasive ventilation: overview, methods. Medscape 2016. http://emedicine.medscape.com/article/304235-overview (accessed March 2017).Google Scholar
Lapinsky, SE. Endotracheal intubation in the ICU. Crit Care 2015; 19: 258.Google Scholar
Bauman, KA, Hyzy, RC. Endotracheal tube management and complications. UpToDate 2015. http://www.uptodate.com/contents/endotracheal-tube-management-and-complications (accessed March 2017).Google Scholar
Boutonnet, M, Faitot, V, Keita, H. Airway management in obstetrics. Ann Fr Anesth Reanim 2011; 30: 651–64.Google Scholar
Simpson, GD, Ross, MJ, McKeown, DW, Ray, DC. Tracheal intubation in the critically ill: a multi-centre national study of practice and complications. Br J Anaesthesia 2012; 108: 792–9.Google Scholar
Apfelbaum, JL; Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2013; 118: 251–70.Google Scholar
Yang, CP, Veltri, MA, Anton, B, Yaster, M, Berkowitz, ID. Food and Drug Administration approval for medications used in the pediatric intensive care unit: a continuing conundrum. Pediatr Crit Care Med 2011; 12: e195–9.Google Scholar
Royal College of Physicians of Ireland. Guidelines for Safe and Effective Management and Use of Point of Care Testing in Primary and Community Care. Dublin: RCPI, 2008. http://www.acbi.ie/Downloads/Guidelines-for-Point-of-Care-Testing-02.pdf (accessed March 2017).Google Scholar
Brochard, L, Martin, GS, Blanch, L, et al. Clinical review: respiratory monitoring in the ICU – a consensus of 16. Crit Care 2012; 16: 219.Google Scholar
O’Connor, L, McIntosh, D. Management of the circulation on the intensive care unit. Surgery 2012; 30: 543–51.Google Scholar
Leitgeb, J, Mauritz, W, Brazinova, A, at el. Glasgow Coma Scale score at intensive care unit discharge predicts the 1-year outcome of patients with severe traumatic brain injury. Eur J Trauma Emerg Surg 2013; 39: 285–92.Google Scholar
Kellum, JA, Lameire, N; KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care 2013; 17: 204.Google Scholar
Mehta, RL, Kellum, JA, Shah, SV et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007; 11: R31.Google Scholar
Reintam Blaser, A, Malbrain, ML, Starkopf, J, et al. Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems. Intensive Care Med 2012; 38: 384–94.Google Scholar
Dellinger, RP, Levy, MM, Rhodes, A, et al.; Surviving Sepsis Campaign Guidelines Committee. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013; 39(2): 165–228. PMID 23361625.Google Scholar
Sessler, CN, Wilhelm, W. Analgesia and sedation in the intensive care unit: an overview of the issues. Crit Care 2008; 12 (Suppl 3): S1.Google Scholar
De Backer, D, Marx, G, Tan, A, et al. Arterial pressure-based cardiac output monitoring: a multicenter validation of the third-generation software in septic patients. Intensive Care Med 2011; 37: 233–40. PMID 21153399.Google Scholar
Soar, J, Perkins, GD, Abbas, G, et al. European Resuscitation Council Guidelines for Resuscitation 2010, Section 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation 2010; 81: 1400–33.Google Scholar
Ramsay, G, Paglia, M, Bourjeily, G. When the heart stops: a review of cardiac arrest in pregnancy. J Intensive Care Med 2013; 28: 204–14.Google Scholar
Stocchetti, N, Taccone, FS, Citerio, G, et al. Neuroprotection in acute brain injury: an up-to-date review. Crit Care 2015; 19: 186.CrossRefGoogle ScholarPubMed
Kipnis, E, Ramsingh, D, Bhargava, M, et al. Monitoring in the intensive care. Crit Care Res Pract 2012; 2012: 473507.Google Scholar
Mesquida, J, Espinal, C, Gruartmoner, G, et al. Prognostic implications of tissue oxygen saturation in human septic shock. Intensive Care Med 2012; 38: 592–7.Google Scholar
Ait-Oufella, H, Joffre, J, Boelle, PY, et al. Knee area tissue oxygen saturation is predictive of 14-day mortality in septic shock. Intensive Care Med 2012; 38: 976–83.Google Scholar
Bartels, K, Thiele, RH, Gan, TJ. Rational fluid management in today’s ICU practice. Crit Care 2013; 17 (Suppl 1): S6.Google Scholar
Manaker, S. Use of vasopressors and inotropes. UpToDate 2014. http://www.uptodate.com/contents/use-of-vasopressors-and-inotropes (accessed March 2017).Google Scholar
Bangash, MN, Kong, ML, Pearse, RM. Use of inotropes and vasopressor agents in critically ill patients. Br J Pharmacol 2012; 165: 2015–33.Google Scholar
Tracy, C, Boushahri, A. Managing arrhythmias in the intensive care unit. Crit Care Clin 2014; 30: 365–90.Google Scholar
Duarte, AG. ARDS in pregnancy. Clin Obstet Gynecol 2014; 57: 862–70.Google Scholar
Clardy, PF, Reardon, CC. Acute respiratory failure during pregnancy and the peripartum period. UpToDate 2015. http://www.uptodate.com/contents/acute-respiratory-failure-during-pregnancy-and-the-peripartum-period (accessed March 2017).Google Scholar
Skinner, J, McKinney, A. Acute cardiogenic pulmonary oedema: reflecting on the management of an intensive care unit patient. Nurs Crit Care 2011; 16: 193–200.Google Scholar
Lanspa, MJ, Jones, BE, Brown, SM, Dean, NC. Mortality, morbidity, and disease severity of patients with aspiration pneumonia. J Hosp Med 2013; 8: 83–90.Google Scholar
Bartlett, JG. Aspiration pneumonia in adults. UpToDate 2015. http://www.uptodate.com/contents/aspiration-pneumonia-in-adults (accessed March 2017).Google Scholar
De Pascale, G, Bello, G, Tumbarello, M, Antonelli, M. Severe pneumonia in intensive care: cause, diagnosis, treatment and management: a review of the literature. Curr Opin Pulm Med 2012; 18: 213–21.Google Scholar
Santa Cruz, R, Rojas, JI, Nervi, R, Heredia, R, Ciapponi, A. High versus low positive end-expiratory pressure (PEEP) levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome. Cochrane Database Syst Rev 2013; (6): CD009098.Google Scholar
Peek, GJ, Clemens, F, Elbourne, D, et al. CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure. BMC Health Serv Res 2006; 6: 163.Google Scholar
Nair, P, Davies, AR, Beca, J, et al. Extracorporeal membrane oxygenation for severe ARDS in pregnant and postpartum women during the 2009 H1N1 pandemic. Intensive Care Med 2011; 37: 648–54.Google Scholar
Rincon, F, Mayer, SA. Clinical review: critical care management of spontaneous intracerebral hemorrhage. Crit Care 2008, 12: 237.Google Scholar
Lee, BH, Inui, D, Suh, GY, et al. Association of body temperature and antipyretic treatments with mortality of critically ill patients with and without sepsis: multi-centered prospective observational study. Crit Care 2012; 16: R33.Google Scholar
Seif-Eddeine, H, Treiman, DM. Problems and controversies in status epilepticus: a review and recommendations. Expert Rev Neurother 2011; 11: 1747–58.Google Scholar
Alderson, P, Roberts, I. Corticosteroids for acute traumatic brain injury. Cochrane Database Syst Rev 2005; (1): CD000196.Google Scholar
Brophy, GM, Bell, R, Claassen, J, et al.; Neurocritical Care Society Status Epilepticus Guideline Writing Committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 2012; 17: 3–23.CrossRefGoogle ScholarPubMed
Natal, BL. Venous air embolism treatment and management. Medscape 2016. http://emedicine.medscape.com/article/761367 (accessed March 2017).Google Scholar
National Clinical Effectiveness Committee. Sepsis Management. National Clinical Guideline No. 6. Dublin: Department of Health, 2014. http://hse.ie/eng/about/Who/clinical/natclinprog/sepsis/sepsis6.pdf (accessed March 2017).Google Scholar
Van Dillen, J, Zwart, J, Schutte, J, van Roosmalen, J. Maternal sepsis: epidemiology, etiology and outcome. Curr Opin Infect Dis 2010; 23: 249–54.Google Scholar
Blauwet, LA, Cooper, LT. Diagnosis and management of peripartum cardiomyopathy. Heart 2011; 97(23): 1970–81. PMID 22058286.Google Scholar
Cruz, MO, Briller, J, Hibbard, JU. Update on peripartum cardiomyopathy. Obstet Gynecol Clin North Am 2010; 37: 283–303. PMID 20685554.Google Scholar
Royal College of Obstetricians and Gynaecologists. Cardiac Disease and Pregnancy. Good Practice No. 13. London: RCOG, 2011. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/good-practice-13/ (accessed March 2017).Google Scholar
Marik, PE. Venous thromboembolism in pregnancy. Clin Chest Med 2010; 31: 731–40.CrossRefGoogle ScholarPubMed
Leung, AN, Bull, TM, Jaeschke, R, et al.; ATS/STR Committee on Pulmonary Embolism in Pregnancy. An official American Thoracic Society/Society of Thoracic Radiology clinical practice guideline: evaluation of suspected pulmonary embolism in pregnancy. Am J Respir Crit Care Med 2011; 184: 1200–8.Google Scholar
Royal College of Obstetricians and Gynaecologists. Thrombosis and Embolism during Pregnancy and the Puerperium: Reducing the Risk. Green-top Guideline No. 37a. London: RCOG, 2015. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg37a (accessed March 2017).Google Scholar
Bates, SM, Greer, IA, Middeldorp, S, et al.; American College of Chest Physicians. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2 Suppl): e691S–736S.Google Scholar
Clark, SL. Amniotic fluid embolism. Clin Obstet Gynecol 2010; 53: 322–8. PMID 20436307.Google Scholar
Knight, M, Tuffnell, D, Brocklehurst, P, Spark, P, Kurinczuk, JJ; UK Obstetric Surveillance System. Incidence and risk factors for amniotic-fluid embolism. Obstet Gynecol 2010; 115: 910–17. PMID 20410762.Google Scholar
Wada, H, Matsumoto, T, Yamashita, Y. Diagnosis and treatment of disseminated intravascular coagulation (DIC) according to four DIC guidelines. J Intensive Care 2014; 2: 15.Google Scholar
Royal College of Obstetricians and Gynaecologists. Blood Transfusions in Obstetrics. Green-top Guideline No. 47. London: RCOG, 2015. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg47 (accessed March 2017).Google Scholar
Conde-Agudelo, A, Romero, R. Amniotic fluid embolism: an evidence-based review. Am J Obstet Gynecol 2009; 201: 445.e1–13. PMID 1987939367.Google Scholar
Scully, M, Hunt, BJ, Benjamin, S, et al.; British Committee for Standards in Haematology. Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies. Br J Haematol 2012; 158: 323–35.Google Scholar
Fonseca, JE, Méndez, F, Cataño, C, Arias, F. Dexamethasone treatment does not improve the outcome of women with HELLP syndrome: a double-blind, placebo-controlled, randomized clinical trial. Am J Obstet Gynecol 2005; 193: 1591–8. PMID 16260197.Google Scholar
Woudstra, DM, Chandra, S, Hofmeyr, GJ, Dowswell, T. Corticosteroids for HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome in pregnancy. Cochrane Database Syst Rev 2010; (9): CD008148.Google Scholar
Lee, RH, Tran, TT. Acute fatty liver in pregnancy. UpToDate 2015. http://www.uptodate.com/contents/acute-fatty-liver-of-pregnancy (accessed March 2017).Google Scholar

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