Pregnancy, delivery and the intensive care unit: need, outcome and management

PURPOSE OF REVIEW: Increasing numbers of sick pregnant and peripartum women are cared for in the intensive care unit. This review looks at the current mortality, the disease severity of admitted patients and the current need for intensive care unit and high dependency unit beds to cater for these women. It also looks at some recent advances in the treatment of some specific disease entities encountered in the intensive care unit in pregnant women and parturients which have been covered in the 2001-2002 literature. RECENT FINDINGS: There has been a substantial fall in intensive care unit mortality in the last decade and there is a definite place for these women in intensive care unit. They represent a subgroup of severely ill patients with a need for intensive treatment and monitoring and who are worth the investment in time and money because they often recover from their acute illness to return to full productivity. SUMMARY: The high dependency unit and intensive care unit and their role in the service to the pregnant woman and parturient are the main focus of this review which looks at the last 2 years' literature to determine the critical care services' worth and efficacy. In almost all countries, even in the smaller regional hospitals, the intensive care units and high dependency units have reduced maternal mortality and morbidity. The neonatal high dependency units have done much the same for the newborn but the neonatal literature is not reviewed for the purposes of this symposium.