Nursing Care of Pregnant Patients in the Intensive Care Unit

Öz

Physiological changes occurring during pregnancy may, in some cases, necessitate admission to the intensive care unit (ICU). Pregnant patients admitted to the ICU typically require intensive medical care due to conditions such as preeclampsia, eclampsia, Haemolysis, Elevated Liver enzymes, and Low Platelet count syndrome (HELLP) syndrome, sepsis, postpartum haemorrhage, and cardiopulmonary complications. This review article discusses the fundamental principles of nursing care for pregnant patients in the ICU, management strategies for physiological changes, the multidisciplinary team approach, and recommendations for improving patient outcomes. A comprehensive evaluation of clinical nursing practices is provided based on a literature review of current scientific studies.

Anahtar Kelimeler

• Pregnancy
• Intensive Care
• Nursing Care
• Maternal Morbidity
• Obstetric Care.

Kaynakça

1. American College of Obstetricians and Gynecologists. Guidelines for perinatal care. 8th ed. Washington (DC): ACOG; 2019.
2. World Health Organization. Trends in maternal mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Geneva: WHO; 2020.
3. Zieleskiewicz L, Martin C, Leone M. Maternal critical care and obstetric complications requiring ICU admission. Anaesth Crit Care Pain Med 2016;35(5):401-9. doi:10.1016/j.accpm.2016.07.003.
4. Crozier TM. Maternal critical care: Incidence, indications, and outcomes. Int J Obstet Anesth 2017;32(1):50-6. doi:10.1016/j.ijoa.2016.09.003.
5. Krawczyk P, Zielińska K, Nowak P. Postpartum complications requiring intensive care. BMC Pregnancy Childbirth 2021;21(1):125. doi:10.1186/s12884-021-03638-5.
6. Plante LA, Pacheco LD, Saade GR. Hypertensive disorders of pregnancy and maternal cardiovascular risk. Am J Obstet Gynecol 2019;220(2):167-75. doi:10.1016/j.ajog.2018.10.007.
7. Kerimoğlu O, Ezveci H. Sepsis in pregnancy: Risk factors and management strategies. J Matern Fetal Neonatal Med 2020;33(18):3087-92. doi:10.1080/14767058.2019.1687528.
8. Kılıçaslan B. Critical illness in pregnancy and intensive care. JARSS 2022;30(4):213-24.

9. World Health Organization. Maternal sepsis guidelines. WHO Maternal Health Series. Geneva: WHO; 2020.
10. Obstetric hemorrhage: An evidence-based review. Am J Obstet Gynecol 2021;225(3):245-59.
11. Chelmow D, Fridman D, D'Alton ME, et al. Best practices for managing critically ill pregnant women. J Perinat Med 2020;48(6):581-92.
12. Wong MK, Lao TT, Sahota DS, et al. Intensive care management of pregnant patients: A review. Curr Opin Anaesthesiol 2018;31(3):287-92.
13. Bauer ME, Tsen LC. Cardiopulmonary changes in pregnancy. Best Pract Res Clin Anaesthesiol 2019;33(2):233-49.
14. Herdman TH, Kamitsuru S, editors. NANDA hemşirelik tanıları: Tanımlar ve sınıflama 2021–2023. Karadakovan D, çeviri editörü. Ankara: Nobel Tıp Kitabevleri; 2021.
15. Bulechek GM, Butcher HK, Dochterman JM, Wagner CM. Hemşirelik girişimleri sınıflaması (NIC). 6. baskı. Ovayolu F, Ovayolu H, çeviri editörleri. Ankara: Nobel Tıp Kitabevleri; 2017.
16. Mhyre JM, D'Oria R, Hameed AB, et al. The maternal early warning criteria: A proposal from the national partnership for maternal safety. Obstet Gynecol 2014;124(4):782-6.
17. Brown CM, Garovic VD, Brost BC, et al. Hypertensive disorders of pregnancy and maternal cardiovascular disease risk. J Am Coll Cardiol 2019;73(4):323-34.