Neurocritical care of the pregnant patient

Martina S. Burn, Sangini S. Sheth, Kevin N. Sheth

Research output: Chapter in Book/Report/Conference proceedingChapter

3 Scopus citations

Abstract

Introduction: An estimated 0.1%–0.8% of obstetric patients require admission to an intensive care unit (ICU) during pregnancy or the puerperium. When neurologic emergencies occur in pregnancy, collaboration between the neurointensivist, obstetric anesthesiologist, and obstetrician is key in minimizing morbidity and mortality. Principles: Care of the critically ill pregnant patient mirrors that of the critically ill nonpregnant patient with some minor exceptions. Special care must be taken to consider the normal physiologic changes of pregnancy as well as possible fetal exposure to medical interventions. Timing and method of delivery must be carefully considered when caring for patients with neurologic emergencies. Common neurologic emergencies in pregnancy include hypertensive disorders of pregnancy, intracranial neoplasms, noneclamptic seizures, cerebrovascular disorders, and ventriculoperitoneal shunt malfunctions. Conclusion: While neurologic emergencies in pregnancy are overall rare, when they do occur, they can be devastating. As in the nonpregnant population, prompt recognition and rapid intervention are crucial in optimizing patient outcomes. When neurologic emergencies occur in pregnancy, maternal and fetal care is optimized through a multidisciplinary care team.

Original languageEnglish (US)
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages205-213
Number of pages9
DOIs
StatePublished - 2020
Externally publishedYes

Publication series

NameHandbook of Clinical Neurology
Volume171
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152

Bibliographical note

Publisher Copyright:
© 2020 Elsevier B.V.

Keywords

  • Cerebrovascular disorder
  • Eclampsia
  • Epilepsy
  • Neoplasm
  • Neurocritical emergencies
  • Ventriculoperitoneal shunt malfunction

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