Obstetric Critical Care: Overview of Relevant Issues
Bhiwal Kumar Anil Gupta Sunanda*
Critically ill obstetric patients present a unique challenge to the obstetrician, anaesthesiologist and intensivists. Maternal mortality has shown a sharp decline in the developed countries but in developing countries it is still high due to lack of good maternal antenatal services and obstetric intensive care. The indications for admission of a parturient to an ICU are obstetric complications as well as non obstetric indications. Optimal management of the critically ill obstetric patient involves early detection and multi disciplinary approach with close collaboration of the critical care team including obstetricians, midwives, anesthesiologists and neonatologists based on knowledge of physiological and pharmacological alterations. This article aims to provide a comprehensive review for the management of critically ill obstetric patient including monitoring, ventilator strategies, drugs, nutrition, thromboprophylaxis, prognostic indicators and recent update on commonly encountered situations.