Current Women's Health Reviews - Volume 7, Issue 2, 2011

Pregnant or postpartum patients requiring intensive care unit (ICU) admission account for less than 2% of the whole ICU population in developed countries, but they can reach up to 10-15% in developing regions. However, the great impact of these patients' admission to the ICU is more important than the actual number of patients admitted. Critically ill Obstetric patients represent a unique group of patients with particul Read More

This review briefly updates issues related to physiology of pregnancy and peripartum period, maternal mortality and obstetric ICU admissions. Maternal mortality (MM) is still a frequent event, occurring mainly in developing countries. Causes of MM vary: in developed countries, complications of anaesthesia/caesarean section (20%), hypertensive disorders (16%), embolism (15%) and hemorrhage (13%) prevail. I Read More

Preeclampsia is still one of the leading causes of maternal and fetal morbidity and mortality. Improved understanding of the etiology of the disorder has not yet led us to a treatment paradigm which improves maternal and fetal morbidity and mortality in all instances. The degree of severity of preeclampsia is a continuum. However, based on certain criteria and in an attempt to de prevent bad outcome the presentation of the d Read More

The HELLP syndrome (haemolysis, elevated liver enzymes, low platelet count) is a variant of the pre-eclampsia/eclampsia syndrome occurring in 10-20% of patients whose diseases are labelled as severe. Although the majority of cases of HELLP syndrome occur antepartum, the disease can present in the postpartum period, usually within 48 hours of delivery. Hypertension and proteinuria may not be detected in 10-20% of ca Read More

Obstetric haemorrhage refers to any bleeding that occurs during pregnancy, delivery or in the postpartum period. It is associated with maternal morbidity and remains the leading cause of direct maternal deaths in developing countries. Antepartum haemorrhage (APH) refers to any genital tract bleeding prior to the delivery of the baby. Identifiable causes of APH include placenta praevia, placental abruption, vasa praevia an Read More

The pregnant woman is at risk of several pregnancy-specific conditions that may cause respiratory failure, as well as many conditions that are aggravated by the pregnant state. These conditions include pulmonary edema secondary to preeclampsia, amniotic fluid embolism, ARDS due to pregnancy complications and other causes, as well as aspiration of gastric contents, venous thromboembolism and pre-existing heart di Read More

Unsafe abortion (UA) is still a main cause of maternal mortality in countries with restrictive abortion laws. Our objective was to review current concepts about septic abortion (SA), its epidemiology, diagnosis, management and prevention. A wide variety of methods for inducing abortion exist. Lastly, misoprostol has replaced more dangerous methods. Septic abortion is a polymicrobial ascending infection. It should be sus Read More

Maternal sepsis remains a major preventable cause of morbidity and mortality worldwide. The current epidemic of obesity, diabetes, and cesarean delivery will most certainly increase the risk of infectious morbidity and mortality. Women who undergo cesarean are three times more likely to develop sepsis. Early recognition of cases and prompt treatment are essential to improve outcomes. Most cases of maternal sepsis are Read More

Pulmonary embolism (PE) is a leading cause of maternal mortality during pregnancy and following delivery. Pregnancy is associated with a variety of anatomical, hormonal and biochemical alterations that predispose towards venous thrombosis and PE. A high index of suspicion is critical in making the diagnosis, which can be confirmed by objective testing with lower extremity Doppler ultrasound, lung scintigraphy or CT angi Read More

During pregnancy, the risk of venous thromboembolism (VTE) increases 2-5 fold and pulmonary embolism (PE) remains a leading cause of maternal mortality in developed countries. For pregnant women with suspected deep vein thrombosis (DVT) or PE, the use of serial compression leg ultrasound (CUS) should be considered to exclude DVT whereas a normal ventilation perfusion lung scan likely excludes PE. A compu Read More

Peripartum cardiomyopathy (PPCMP) is a relatively rare form of dilated cardiomyopathy with unknown etiology. A generally accepted definition comprises the following criteria: 1) cardiac failure occurring in the last month of pregnancy or within 5 months after delivery; 2) absence of an alternative cause for the cardiomyopathy; 3) absence of heart disease before the last month of pregnancy and 4) demonstrated left ven Read More

This paper reviews the current concepts and outlines appropriate management of conditions such as epilepsy, headache, benign intracranial hypertension, myasthenia gravis, multiple sclerosis, Bell's palsy and cerebrovascular disorders. It also discusses briefly, labor analgesia and anaesthesia in women with neurological disorders.