ICU · Obs/Gynae

Obstetric emergencies in the ICU

Also known as Pre-eclampsia and eclampsia · HELLP syndrome · Peripartum cardiomyopathy · Amniotic fluid embolism · Sepsis in pregnancy · Postpartum haemorrhage in ICU · Venous thromboembolism in pregnancy · Maternal critical care · Massive obstetric haemorrhage · Pregnancy physiology and ICU implications

Obstetric ICU admissions are rare but high-stakes. Pre-eclampsia/eclampsia: magnesium sulphate for seizure prophylaxis and treatment (4 g IV load, 1-2 g/h; beats diazepam and phenytoin), antihypertensive therapy for severe-range BP (over 160/110), delivery definitive. HELLP syndrome (Haemolysis, Elevated Liver enzymes, Low Platelets): usually preterm, malaise and right upper quadrant pain in 90 percent, hypertension may be absent. Peripartum cardiomyopathy: heart failure with LVEF under 45 percent, last month of pregnancy to 5 months postpartum — treat with pregnancy-safe HF therapy (diuretics, beta-blockers, hydralazine/nitrates, digoxin) plus bromocriptine. Amniotic fluid embolism: sudden cardiovascular collapse plus coagulopathy — high-quality CPR, early echo for right ventricular failure, 1:1:1 haemostatic resuscitation, VA-ECMO for the refractory. Physiological changes of pregnancy alter drug dosing, ventilation, and fluid management.

Checked against its sources on 1 Sept 2026