TY  - CHAP
M1  - Book, Section
TI  - Critical Care Issues in Pregnancy
A1  - Dulu, Alina
A1  - Ragsdale, Ellie S.
A1  - Goffman, Dena
A2  - Oropello, John M.
A2  - Pastores, Stephen M.
A2  - Kvetan, Vladimir
PY  - 1
T2  - Critical Care
AB  - KEY  POINTSCritical  illness  in  obstetrics  can  be  the  result  of  pregnancy-specific  conditions  or  due  to  commonly  seen  critical  care  diagnoses  with  unique-management  considerations  in  pregnancy  as  a  result  of  physiologic  alterations  and  fetal  concerns.Any  pregnant  patient  requiring  ICU  level  care  should  be  in  a  facility  with  obstetric  and  neonatal  teams  for  collaborative  multidisciplinary  care.A  critically  ill  pregnant  patient  is  at  risk  for  labor  and  delivery,  regardless  of  the  initial  inciting  condition.For  patients  who  are  still  pregnant,  in  general,  the  rule  is  for  maternal  stabilization  prior  to  delivery  of  the  fetus.  In  most  cases,  appropriate  treatment  of  the  mother  will  improve  fetal  status.The  American  Heart  Association  publishes  guidelines  for  cardiac  arrest  in  special  situations  including  pregnancy.  Key  interventions  to  prevent  arrest  in  a  critically  ill  pregnant  woman  include  left  lateral  positioning,  100%  oxygen,  IV  access  above  diaphragm,  and  treatment  of  hypotension.In  maternal  cardiac  arrest  not  immediately  reversed  by  basic  life  support  and  advanced  cardiovascular  life  support  (ACLS),  prompt  consideration  for  emptying  the  uterus  must  be  undertaken  (“perimortem  cesarean”).  For  this  to  be  feasible,  resuscitation  teams  must  activate  a  protocol  for  possible  cesarean  delivery  as  soon  as  a  maternal  cardiac  arrest  is  identified.Important  obstetric  conditions  outlined  within  the  text  include  preeclampsia,  eclampsia,  hemolysis,  elevated  liver  enzymes,  and  low  platelets  syndrome,  acute  fatty  liver  of  pregnancy,  anaphylactoid  syndrome  of  pregnancy/amniotic  fluid  embolism,  peripartum  cardiomyopathy,  and  obstetric  hemorrhage.Nonobstetric  conditions  with  a  focus  on  presentation  in  pregnancy  outlined  within  the  text  include  thromboembolic  disease,  severe  sepsis,  septic  shock,  and  multiorgan  failure,  pulmonary  edema,  arrhythmia,  diabetic  ketoacidosis,  and  status  asthmaticus.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1136417851
ER  -