Management of the critically-ill obstetric patient

From 2013 to 2015, 202 women in the United Kingdom died during or within 6 weeks of the end of their pregnancy, as a direct or indirect result of the pregnancy. In one third of cases, care was considered 'good', but in more than one third of cases, improvements in care were identified which may have influenced outcome. Many women received critical care input, ranging from close observation to multi-organ support. An understanding of the types of organ support available, their indications and objectives is important for all medical professionals caring for these unwell women. This review describes technical aspects of critical care organ support and how the physiology of pregnancy influences their use. Life-threatening conditions are highlighted, together with key management recommendations and the importance of a collaborative multi-disciplinary approach. In addition, the unique non-clinical challenges faced by professionals caring for sick pregnant and recently pregnant women, from logistical to psychological, are discussed.