Int J Obstet Anesth. 2025 Oct 17;65:104803. doi: 10.1016/j.ijoa.2025.104803. Online ahead of print.

BACKGROUND: Current gaps in the provision of obstetric critical care in Europe, potentially compromising patient safety and the childbirth experience, have been recognised. However, data on indications for critical care admission from stand-alone obstetric units remain scarce. We evaluated the indications for transfer from a community level 1 obstetric unit to the critical care department of a tertiary referral hospital, and describe management of these obstetric admissions.

METHODS: All obstetric admissions to the high dependency/intensive care unit in a tertiary referral hospital providing critical care services to a level 1 obstetric unit in Ireland were evaluated. Data collected included the indication for transfer, obstetric data, type and number of organ support, length of stay, and maternal outcomes.

RESULTS: Between 2019 and 2023, 81 women were admitted to the critical care department of which 24 were still pregnant (29.6%), with haemorrhage as the most common indication. Obstetric admission represented 0.9% of high dependency and 1.9% of all intensive care unit admissions. Mechanical ventilation occurred in 40% of intensive care admissions, and ≥ 2 types of organ support in 36% of patients. There were no maternal deaths.

CONCLUSION: Less than 0.5% of obstetric patients were transferred from a stand-alone obstetric unit for maternal critical care. Though obstetric patients represented only 1.9% of all intensive care unit admissions in the tertiary referral centre, a significant proportion were admitted before delivery. This emphasizes the importance for critical care staff to be adequately trained and resourced in the management of pregnant and postpartum patients.

PubMed:41289956 | DOI:10.1016/j.ijoa.2025.104803