Implications for the pregnant patient

Critical illness requiring admission to an intensive care unit (ICU) is a r elatively uncommon complication of pregnancy, accounting for less than 1% o f ICU admissions (1). A few illnesses, such as eclampsia, hemorrhage, the H ELLP syndrome (hemolysis, elevated liver enzymes, low platelets), amniotic fluid embolism, and tocolytic-induced pulmonary edema, are specific to the pregnant patient and may lead to ICU admission. However, it is slightly mor e common that nonobstetric diseases occurring in the pregnant patient lead to life-threatening illness. It is not within the scope of this article to review comprehensively all pr oblems that lead to critical illness in the gravid patient. A recent State- of-the-Art in the Journal provides an excellent overview of this broad topi c (2). The management of the critically ill pregnant patient has not change d dramatically in the past decade. Unfortunately, there is a paucity of rec ent data concerning critically ill obstetric patients. This article concent rates on new information regarding the pregnant patient and recent advances in critical care that will he applied to the pregnant patient even though these studies did not include pregnant patients. These topics include sever ity of illness and mortality, asthma, pulmonary edema, ventilatory strategi es, eicosanoids and nitric oxide, and resuscitation.