Cardiopulmonary complications of pregnancy

Abstract

Admission of the pregnant or postpartum woman to the intensive care unit is uncommon but may require specialized knowledge for successful management.

Clinical characteristics and outcomes of obstetric patients admitted to the intensive care unit

“…Death during pregnancy may also be related to age, since mortality is 5-fold higher among pregnant women older than 40 years old than among those younger than 25 years [15]. Overall, few women become sufficiently ill to require hospitalization at an ICU but the normal adaptive physiology of pregnancy and the presence of the fetus make these women different from other critically ill patients [13,14]. Abbreviations: CAP, community-acquired pneumonia; DKA, diabetic ketoacidosis; ICU, intensive care unit.…”

Breathing for Two

“…11 During labor, uterine contractions increase venous return due to the capacitance of the utero-placental circulation, returning 300 to 500 mL of blood to the central circulation and increasing stroke volume and cardiac output by an extra 10% to 20%. 11,13 Preload increases immediately after delivery, maintaining the increased cardiac output until around 48 hours after delivery. 13 These large shifts in preload may be poorly tolerated by patients with diseases characterized by fixed cardiac output, putting them at a high risk of developing pulmonary edema in the peripartum period.…”

“…1,11 Renal compensatory mechanisms increase the urinary excretion of bicarbonate, stabilizing serum bicarbonate levels around 18 to 21 mEq/L. 11,13 Alkalosis and hypocapnia have important implications. Maternal hypocapnia creates a concentration gradient across the placental membrane with fetal PaCO 2 , allowing fetal CO 2 removal.…”

The Effects of Respiratory Failure on Delivery in Pregnant Patients With H1N1 2009 Influenza

“…As is well known, the gravid state has multiple effects on maternal cardiac and respiratory status, including a decrease in functional residual capacity, an increase in cardiac output, and an increase in oxygen demand. 8 Women with multiple gestations have an even greater alteration in baseline cardiorespiratory physiology, 9 which may make them more susceptible to adverse outcomes with respiratory infections. Currently, there are few published data on the effect of multiple gestations on the clinical course of H1N1.…”