A blueprint for obstetric critical care.
OBJECTIVE
The purpose of this study was to describe our 2-year experience with 483 critically ill peripartum women and to propose a blueprint for obstetric critical care.


METHODS
This was a prospective study to evaluate all admissions to the Obstetric Intermediate Care Unit and obstetric admissions to medical/surgical intensive care units. Our findings are followed by general recommendations for the organization of obstetric critical care.


RESULTS
Almost two thirds of the women had obstetric complications that included pregnancy-associated hypertension and obstetric hemorrhage. Medical disorders were most common in the other one third of the women.


CONCLUSIONS
An Obstetric Intermediate Care Unit allows for the continuation of care by obstetricians and results in fewer transfers to medical/surgical intensive care units. Patient treatment depends on hospital size and available resources. In most tertiary centers, the critically ill pregnant woman is best cared for by obstetricians in an Obstetric Intermediate Care Unit. In smaller hospitals, transfer to a medical or surgical intensive care unit may be preferable.
Zeeman
Gerda G
GG
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, USA. Veth-zeeman@planet.nl
Wendel
George D
GD
Cunningham
F Gary
FG
D003422:Critical Care; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy; D007362:Intensive Care Units; D007380:Intermediate Care Facilities; D008485:Medical Audit; D009774:Obstetrics / Q000379:methods*; D010343:Patient Admission; D010360:Patient Transfer; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy; D011446:Prospective Studies; D014592:Uterine Hemorrhage / Q000628:therapy