Critical Care Time 45. Obstetric Emergencies with Dr. Stephanie Levine and Dr. Adam Mora
Mar 24, 2025
Dr. Stephanie Levine, a pulmonary expert and former president of Chest, teams up with Dr. Adam Mora, an intensivist focused on obstetric and transgender critical care. They dive into the high-stakes world of obstetric emergencies, discussing lifesaving strategies like resuscitative C-sections and managing postpartum hemorrhage. The conversation touches on physiological changes during pregnancy, the complexities of intubation, and the need for enhanced training in critical care. Together, they emphasize collaboration among specialists to improve outcomes for mothers and babies in crisis.
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Airway Management in Pregnant Patients
- For pregnant women needing intubation, avoid non-invasive ventilation due to aspiration risk.
- Opt for higher FiO2, high flow, or rapid sequence intubation (RSI) with a smaller endotracheal tube.
Positioning for Hypotension Post-Intubation
- Hypotension post-intubation in pregnant women can be addressed by switching to the left lateral decubitus position.
- This alleviates pressure on the IVC caused by the gravid uterus.
Additional Airway Considerations
- In pregnant patients, avoid nasotracheal intubation and be prepared for potential airway bleeding.
- Maintain oxygen saturation above 95% to prevent fetal distress.