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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.
01:38:29

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Quick takeaways

  • Timely resuscitative C-sections within five minutes significantly enhance CPR outcomes for pregnant patients in critical situations.
  • A multidisciplinary approach involving obstetricians and intensivists is essential for effectively managing complex obstetric emergencies in the ICU.

Deep dives

Importance of Resuscitative C-Section

For pregnant individuals in crisis, particularly those around 24 weeks or at the level of the umbilicus, a resuscitative C-section is crucial for successful CPR outcomes. This procedure should be performed approximately within five minutes of recognizing the situation, as timely delivery helps relieve uterine compression and improves venous return. The decision to proceed with the C-section should ideally occur by the four-minute mark, since most OBs can extricate the baby swiftly thereafter. The improved blood flow gives rise to better chest compressions, greatly increasing the chances for both mother and child.

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