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Pulmonary Problems in Pregnancy pp 331–354Cite as

Critical Illness in Pregnancy

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Abstract

The gravid patient will typically experience few difficulties during the course of her pregnancy. A small but significant number of pregnant patients will become ill enough to require the intensive care unit for both obstetrical and non-obstetrical problems. Therefore, the obstetrical physician must have an understanding of how to monitor and manage the critically ill pregnant patient and how to approach emergencies unique to pregnancy. In a report of ICU utilization during hospital admission for delivery in the United States in one state, 822,591 admissions from 1984 to 1997 were analyzed. There were 1,023 admissions to the intensive care unit, with mortality in the ICU of 3.3% (1). Predictors for ICU admission in this retrospective analysis included: age greater than 35 (Odds Ratio [OR] 1.4), African-American ethnicity (OR 1.8), race other than black or white (OR 5.9), treatment in minor teaching hospital (OR 2.0), and transfer to a higher-level hospital for care (OR 2.51) (1). The most common indication for ICU admission involved obstetrical related complications. These included complications of cesarean section, preeclampsia or eclampsia, and peripartum hemorrhage (1–4). The most common risk factors associated with ICU mortality included pulmonary complications, shock, cerebrovascular events, and drug dependence(1). In another study looking at 74 obstetric patients admitted to an ICU over 7 years, the most common reason for admission was respiratory insufficiency (5). Outside of the United States, a much smaller study of ICU admissions in the United Arab Emirates demonstrated similar mortality rates (6). In another series, a majority of obstetric patients admitted (71%) to the ICU required ventilatory support (7).

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  1. Department of Medicine, Pulmonary and Critical Care Medicine, University of Chicago, 5841 South Maryland, MC 6076, Chicago, IL 60637, USA

    D. Kyle Hogarth MD (Assistant Professor of Medicine) & Jesse Hall MD (Professor of Medicine and Anesthesia & Critical Care Section Chief, Pulmonary and Critical Care Medicine)

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    © 2009 Humana Press, a part of Springer Science+Business Media, LLC

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    Hogarth, D.K., Hall, J. (2009). Critical Illness in Pregnancy. In: Rosene-Montella, K., Bourjeily, G. (eds) Pulmonary Problems in Pregnancy. Respiratory Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-445-2_21

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    • DOI: https://doi.org/10.1007/978-1-59745-445-2_21

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