Management of the critically-ill obstetric patient

From 2009 to 2012, 321 women in the United Kingdom died during or within six weeks of the end of their pregnancy, as a direct or indirect result of the pregnancy. Many received critical care input which varied from observation to multi-organ support. In many women death occurred despite optimal care, but in over half of cases there were opportunities missed that could have made a difference to outcome.An understanding of the different types of organ support and treatment that are available, and when these are indicated is important for medical professionals caring for these unwell obstetric patients.This review describes the technical aspects of organ support that can be provided in a critical care setting and the alterations in physiology occurring during pregnancy that influence the use of each treatment modality. Also addressed in more detail are conditions that can be life-threatening in pregnancy, together with key points about management of these conditions when they necessitate critical care support.