Features  |   May 2019
Maternal Critical Care: The Intensivist’s Place in the Obstetric Care Team
Author Affiliations
  • David L. Stahl, M.D.
    Committee on Critical Care Medicine
  • Moumen F. Asbahi, M.D.
    Committee on Critical Care Medicine
Article Information
Critical Care / Obstetric Anesthesia / Features
Features   |   May 2019
Maternal Critical Care: The Intensivist’s Place in the Obstetric Care Team
ASA Monitor 5 2019, Vol.83, 22-24.
ASA Monitor 5 2019, Vol.83, 22-24.
Sitting around the table were a cluster of maternal fetal medicine obstetricians, a gaggle of cardiologists and a troop of nurses from across the hospital. An obstetric anesthesiologist and a critical care anesthesiologist joined the fray. At the center of the discussion was a 26-year-old parturient with a complex history of congenital heart disease. She was 32 weeks pregnant and had pulmonary hypertension on continuous I.V. prostacyclin.
Critically ill obstetric patients are becoming increasingly common. This may be in part due to the increasing age1  and changes in maternal health2  as well as specific efforts to improve maternal morbidity and mortality. Some of these efforts include improved surgical and medical management of patients with congenital disease, thereby increasing the number of patients in the reproductive stage.3  In response to a complex patient population and rising maternal mortality, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have developed guidelines to transfer these patients to facilities with appropriate resources. Under the newly proposed “Levels of Maternal Care” classifications, patients with congenital heart disease (among other comorbidities) now trigger requirements for critical care services by obligating care in level III or IV facilities, the highest level of designation for these newly developed guidelines.4 
0 Comments
Submit a Comment
Submit A Comment

Contributors must reveal any conflict of interest. Comments are moderated.

Name
Affiliation & Institution
I have a potential conflict of interest
Comment Title
Comment


This feature is available to Subscribers Only
ASA Member Login or Create an Account ×