Respiratory Considerations Including Airway and Ventilation Issues in Critical Care Obstetric Patients

Obstet Gynecol Clin North Am. 2016 Dec;43(4):699-708. doi: 10.1016/j.ogc.2016.07.002.

Abstract

Critical care management of the obstetric patient can present unique challenges. Parturients who present with respiratory distress can suffer from a multitude of etiologies, and each diagnosis must be pursued as appropriate to the clinical picture. Normal physiologic changes of pregnancy may obscure the presentation and diagnosis, and irrelevant of the cause, pregnancy may complicate the management of hypoxic and hypercarbic respiratory failure in this patient population. In addition to these concerns, both anticipated and unanticipated difficult airway management, including difficulty ventilating and intubating, are more common during pregnancy and may be encountered during endotracheal tube placement.

Keywords: Acute respiratory distress syndrome; Airway changes of pregnancy; Extracorporeal membrane oxygenation during pregnancy; Lung protective ventilation; Reactive airway disease in pregnancy.

Publication types

  • Review

MeSH terms

  • Airway Management / methods*
  • Critical Care / methods*
  • Female
  • Humans
  • Obstetric Labor Complications / diagnosis
  • Obstetric Labor Complications / etiology
  • Obstetric Labor Complications / physiopathology
  • Obstetric Labor Complications / therapy
  • Patient Care Management
  • Pregnancy
  • Respiratory Insufficiency / diagnosis
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / therapy