Critical Care in Obstetrics: A Strategy for Addressing Maternal Mortality

Abstract

(Am J Obstet Gynecol. 2021;224:567–573) Given a 200% increase from 1993 to 2014 of severe maternal morbidity, it is imperative to look for mechanisms to decrease risk and possible associated maternal deaths. For the estimated 1 to 3 percent of all obstetrical patients who require intensive care unit (ICU) level care, best outcomes are achieved when a collaborative care model utilizing intensivists and maternal fetal medicine (MFM) specialists is possible. However, with an increasingly more complicated obstetrical population and no concomitant rise in MFM specialists there is an important role for broadening the skill sets for health care providers and resources for facilities that are lacking in advanced care. The authors suggest that using evidence-based tools for patient risk stratification, rapid diagnosis of life-threatening conditions, access to consultation by critical care specialists and better education regarding critical care for all obstetrical providers would lead to less maternal morbidity and mortality. The focus of the authors’ clinical opinion was to evaluate the best screening tools for high risk obstetrical patients as well as advocating for more critical care resource accessibility on Labor and Delivery.