Current Anesthesiology Reports

, Volume 7, Issue 1, pp 55–66 | Cite as

Maternal Critical Illness

Obstetric Anesthesia (LR Leffert, Section Editor)
Part of the following topical collections:
  1. Obstetric Anesthesia

Abstract

Purpose of Review

The purpose of this study was to define maternal critical illness (MCI) and outline its causes, the tools used to identify it, and current treatment recommendations.

Recent Findings

Although MCI is uncommon, it comprises >10% of intensive care (ICU) admissions in women aged <50 years. Of critically ill mothers, 1:20 die. Almost half these deaths are preventable. Monitoring should follow convention, yet MCI is often treated outside ICUs. Patient youth and the relative rarity of MCI often lead to underestimation of risk and delays in care. Imaging is underutilized. There is no information regarding mechanical ventilation targets. Data regarding drug safety is derived from non-critically ill pregnant women and from retrospective case-control studies which often overestimate risk.

Summary

MCI is accompanied by significant excess mortality. Imaging studies, treatments, or medication should not be withheld from cases of MCI solely due to concerns regarding fetal outcome. There remain important knowledge gaps in both diagnosis and treatment of MCI.

Keywords

Pregnancy complications Peripartum Critical care Pregnancy Hemorrhage Postpartum hemorrhage Eclampsia Pre-eclampsia Sepsis 

Notes

Acknowledgements

We give thanks to Nechama Kaufman for patiently organizing, reorganizing, and again reorganizing the reference list with every change that we made to this manuscript.

Compliance with Ethical Standards

Conflict of Interest

Sharon Einav, Ruben Bromiker, and Hen Y. Sela declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Funding

This review received no funding from any sources.

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Copyright information

© Springer Science + Business Media New York 2017

Authors and Affiliations

  1. 1.Anesthesia and Intensive Care Medicine, Surgical Intensive CareHebrew University School of Medicine, Shaare Zedek Medical CentreJerusalemIsrael
  2. 2.Department of Neonatal Intensive Care UnitSchneider Children’s Medical Center of IsraelPetah TikvaIsrael
  3. 3.Department of Obstetrics and GynecologyShaare Zedek Medical CentreJerusalemIsrael

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