Critical care in obstetrics

Abstract

Leading causes of intensive care unit (ICU) admission include hemorrhage, hypertensive disorders of pregnancy, and sepsis. Although the incidence of ICU admission in pregnancy may be low, this does not account for critical illness in labor and delivery or maternity unit suites, which is as high as 1-3%. Most admissions, for example, to an ICU unit occur in the postpartum period, where studies have shown a range from 62 to 92% of admissions occurring during this period. A total of 60% of maternal deaths have been reported as preventable, with a delay in diagnosis and prompt medical treatment cited as primary factors, prompting for early recognition of high-risk obstetric patients. Recently, comorbidity-based screening tools, which quantify a patient's medical comorbidity burden, have been developed and validated in predicting ICU admission and death. Noninvasive ultrasonography such as point-of-care ultrasonography becomes essential in determining hemodynamic status, guides resuscitation, and manages cardiovascular dysfunction.

Keywords: echocardiography; intensive care unit; obstetric comorbidity index; point-of-care ultrasound.