Critical Care Obstetrics

JEFFREY P. PHELAN MD, JD, Department of Obstetrics and Gynecology, Citrus Valley Medical Center, West Covina, CA, President & Director of Clinical Research, Childbirth Injury Prevention Foundation, Glendora, CA, USA.

LUIS D. PACHECO MD, Professor, Departments of Obstetrics, Gynecology, and Anesthesiology, Divisions of Maternal Fetal Medicine and Surgical Critical Care, The University of Texas Medical Branch, Galveston.

MICHAEL R. FOLEY MD, Professor and Chair, Department of Obstetrics and Gynecology, University of Arizona College of Medicine Phoenix.

GEORGE R. SAADE MD, Professor, Departments of Obstetrics and Gynecology and Cell Biology, Chief of Obstetrics and Maternal-Fetal Medicine, The University of Texas Medical Branch, Galveston, TX, USA.

GARY A. DILDY III MD, Professor of Obstetrics & Gynecology, Baylor College of Medicine, TX, USA.

MICHAEL A. BELFORT MD, PhD, Professor, Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, TX, USA.

List of Contributors ix


Foreword to the Sixth Edition xvii


Part One Basic Critical Care Clinical and Surgical Principles 1


1 Epidemiology of Critical Illness in Pregnancy 3
Cande V. Ananth and John C. Smulian


2 Organizing an Obstetrical Critical Care Unit: Care without Walls 17
Julie Scott and Michael R. Foley


3 Critical Care Obstetric Nursing 27
Nan H. Troiano and Suzanne McMurtry Baird


4 Pregnancy?Induced Physiologic Alterations 41
Errol R. Norwitz and Julian N. Robinson


5 Maternal Blood Gas Physiology 69
Aaron B. Caughey


6 Fluid and Electrolyte Balance 87
William E. Scorza, Sharon Maynard, and Anthony Scardella


7 Interventional Radiology in Pregnancy 115
Sheena A. Pimpalwar and Michael A. Belfort


8 Fetal Considerations in the Critically Ill Gravida 123
Jeffrey P. Phelan


9 Fetal Effects of Drugs Commonly Used in Critical Care 151
Sarah Gloria Obi?an and Jerome Yankowitz


10 Maternal?Fetal Oxygenation 175
Alfred D. Fleming and Marsha Henn


11 Cardiopulmonary Resuscitation (CPR) in Pregnancy 183
Terri?Ann Bennett and Carolyn M. Zelop


12 Neonatal Resuscitation 193
Jay P. Goldsmith and Gilbert I. Martin


13 Ventilator Management in Critical Illness 215
Luis D. Pacheco and Antonio Saad


14 Vascular Access 249
Gayle Olson and Aristides P. Koutrouvelis


15 Nutritional Support 265
Bill Tang, Michael J. Tang, and Jeffrey P. Phelan


16 Dialysis in Pregnancy 273
Evan I. Fisher, Shad H. Deering, and James D. Oliver III


17 Cardiopulmonary Bypass 285
Alexis L. McQuitty


18 Noninvasive Monitoring in Critical Care 303
Amir Shamshirsaz and Michael A. Belfort


19 Obstetric Analgesia and Anesthesia 315
M. James Lozada, Rovnat Babazade, and Rakesh B. Vadhera


20 Critical Care Drills in Obstetrics 331
Monica A. Lutgendorf and Shad H. Deering


21 Maternal?Fetal Transport in the High?Risk Pregnancy 347
Albert P. Sarno, Joshua A. Makhoul, and John C. Smulian


Part Two Acute Emergencies 359


22 Seizures and Status Epilepticus 361
Michael W. Varner


23 Acute Spinal Cord Injury 369
Lisa R. Wenzel, Angela Vrooman, and Hunter A. Hammill


24 Severe Acute Asthma 391
Dharani K. Narendra and Nicola A. Hanania


25 Acute Respiratory Distress Syndrome in Pregnancy 403
Dharani K. Narendra, David Muigai, and Kalpalatha K. Guntupalli


26 Cardiogenic Pulmonary Edema 419
Wayne J. Franklin and William C. Mabie


27 The Acute Abdomen during Pregnancy 429
Ibrahim A. Hammad and Howard T. Sharp


28 Acute Pancreatitis 441
Anna S. Leung and Jeffrey P. Phelan


29 Acute Renal Injury 457
Kristen L. Elmezzi, Caroline C. Marrs, C. Luke Dixon, Shad H. Deering, and Giuseppe Chiossi


30 Acute Fatty Liver of Pregnancy 471
Ibrahim A. Hammad and T. Flint Porter


31 Disseminated Intravascular Coagulation 479
Nazli Hossain and Michael J. Paidas


32 Endocrine Emergencies 487
Mary Catherine Tolcher, Heather S. Hoff, and Kjersti Marie Aagaard


33 Acute Psychiatric Conditions in Pregnancy 501
Lucy J. Puryear


34 Diabetic Ketoacidosis 519
Mark A. Curran


Part Three Shock in Pregnancy 533


35 Hypovolemic Shock 535
Jerasimos Ballas and Scott Roberts


36 Blood Component Therapy and Massive Transfusion 547
Shiu?Ki Rocky Hui, Kjersti Marie Aagaard, and Jun Teruya


37 Etiology and Management of Hemorrhage 569
Irene A. Stafford, Michael A. Belfort, and Gary A. Dildy


38 Septic Shock 599
Sonya S. Abdel?Razeq and Errol R. Norwitz


39 Cardiogenic Shock 631
Scott Roberts and Martha W.F. Rac


40 Anaphylactic Shock in Pregnancy 641
Raymond O. Powrie


41 Amniotic Fluid Embolism 653
Gary A. Dildy, Michael A. Belfort, and Steven L. Clark


Part Four Medical and Surgical Management 671


42 Pregnancy?Related Stroke 673
Jamil ElFarra and James N. Martin, Jr.


43 Cardiac Disease and Pregnancy 699
Wayne J. Franklin, Roxann Rokey, Michael R. Foley, and Michael A. Belfort


44 Anesthetic Considerations in the Critically Ill Gravida with Cardiac Disease 731
Shobana Murugan, Lisa Mouzi Wofford, Sandeep Markan, and Yi Deng


45 Thromboembolic Disease 755
Martha Pritchett Mims


46 Pulmonary Hypertension in Pregnancy 775
Mohammed F. Zaidan and Alexander G. Duarte


47 Sickle Cell Disease and Pregnancy 791
Iberia Romina Sosa and Mark M. Udden


48 Thrombotic Thrombocytopenic Purpura, Hemolytic?Uremic Syndrome, and HELLP 803
Kelty R. Baker


49 The Placenta as a Critical Care Issue 821
Karin A. Fox, Martha W.F. Rac, Alireza A. Shamshirsaz, and Michael A. Belfort


50 Complications of Preeclampsia 837
Mary Catherine Tolcher, Hector Mendez?Figueroa, and Kjersti Marie Aagaard


51 Systemic Lupus Erythematosus and Antiphospholipid Syndrome 873
Fawzi Saoud and Maged M. Costantine


52 Trauma in Pregnancy 891
Robert Rossi, Alfredo F. Gei, and James W. Van Hook


53 Thermal and Electrical Injury 919
Cornelia R. Graves


54 Overdose, Poisoning, and Envenomation during Pregnancy 927
Alfredo F. Gei, Victor R. Suarez, and James W. Van Hook


55 The Organ Transplant Patient in the Obstetric Critical Care Setting 985
Calla Holmgren and James R. Scott


56 Fetal Surgery Procedures and Associated Maternal Complications 997
Alireza A. Shamshirsaz, Venkata Bandi, David Muigai, R. H. Ball, and Michael A. Belfort


57 Cancer in the Pregnant Patient 1005
Kristin Bixel, Kenneth H. Kim, and David M. O'Malley


58 Mass Casualties and the Obstetrical Patient 1023
Lisa M. Foglia and Peter E. Nielsen


59 Biological, Chemical, and Radiological Exposures in Pregnancy 1027
Lisa M. Foglia and Peter E. Nielsen


Part Five Ethical and Legal Considerations 1037


60 Ethics in the Obstetric Critical Care Setting 1039
Fidelma B. Rigby


61 Medical?Legal Considerations in Critical Care Obstetrics 1063
Jeffrey P. Phelan


Index 1085