医学
介绍
人口
产妇发病率
重症监护
心理干预
护理部
医疗急救
重症监护医学
怀孕
环境卫生
遗传学
生物
作者
César Padilla,Metabel Markwei,Sarah Rae Easter,Karin A. Fox,Amir A. Shamshirsaz,Michael Foley
标识
DOI:10.1016/j.ajog.2020.12.1208
摘要
The acute rise in maternal morbidity and mortality in the United States is in part because of an increasingly medically complex obstetrical population. An estimated 1% to 3% of all obstetrical patients require intensive care, making timely delivery and availability of critical care imperative. The shifting landscape in obstetrical acuity places a burden on obstetrical providers, many of whom have limited experience in identifying and responding to critical illness. The levels of maternal care definitions by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine designate hospitals based on the availability of obstetrical resources and highlight the need for critical care resources and expertise. The growing need for critical care skills in the evolving contemporary obstetrical landscape serves as an opportunity to redefine the concept of delivery of care for high-risk obstetrical patients. We summarized the key tenets in the prevention of maternal morbidity and mortality, including the use of evidence-based tools for risk stratification and timely referral of patients to facilities with appropriate resources; innovative pathways for hospitals to provide critical care consultations on labor and delivery; and training of obstetrical providers in high-yield critical care skills, such as point-of-care ultrasonography. These critical care–focused interventions are key in addressing an increasingly complex obstetrical patient population while providing an educational foundation for the training of future obstetrical providers.
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