Monothematic meeting of SfarIntensive care and pregnancy: Epidemiology and general principles of management of obstetrics ICU patients during pregnancy☆,☆☆
Introduction
Physiological changes associated with pregnancy make the obstetric patients a specific intensive care unit (ICU) population. They represent a small but important population in which the intensivist is in charge of two patients instead of one. This review will discuss the epidemiology of this population. We then outline how parturients in the prepartum period can be treated according to the best knowledge of literature during pregnancy.
Section snippets
Method
This review was performed by a group including epidemiologists, anesthesiologists, intensivists and midwives.
Literature was explored using Pubmed database from 2000 to 2015. The following key words were used: pregnancy, obstetric, parturient and critical care, intensive care, critical illness, preeclampsia. Experimental studies, original studies, reviews and case reports were assessed. Manuscripts in English and French languages were considered for analysis.
Epidemiology
Although pregnancy and childbirth are generally healthy events, they nevertheless can be in some cases associated with maternal complications that can worsen and lead to maternal death. The current changes in the profile of parturient women (increase in the age at conception, in the rate of twin pregnancies or the rate of obese women) and in obstetric practices (more caesarean sections, inductions of labor) may lead to an increasing risk of maternal complications [1], [2], [3], [4], [5].
Conclusion
The ICU management of parturient during pregnancy is challenging due to the implication of two patients in the same time. A multidisciplinary management made by experienced practitioners and a good knowledge of the pregnancy-induced physiological changes are therefore necessary.
Disclosure of interest
The authors declare that they have no competing interest.
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Cited by (0)
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Article presented at Monothematic meeting of Société Française d’Anesthésie et de Réanimation (Sfar): “Urgence, anesthésie et réanimation de la femme enceinte”, Paris, May 16, 2016.
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This article is published under the responsibility of the Scientific Committee of the “Journée monothématique 2016 de la Sfar”. The editorial board of the Anaesthesia Critical Care & Pain Medicine was not involved in the conception and validation of its content.