1. Wael Batobara FRCP Canada Internal medicine, Pulmonary & Critical Care Medicine ABIM Internal medicine, Pulmonary & Critical Care Medicine

2. Why The Fear? Concern of inadequate knowledge Previous bad experience Dealing with two individuals How come a natural process ending up in a disease status

3. By The End of The Talk Incidence of ICU admission & outcomes Pregnancy related diseases  Preclampsia, Eclampsia & HELLP Massive hemorrhage,Amniotic fluid embolism CPR on a pregnant patient CVS illnesses worsened during pregnancy  CHF, Arrhythmia & Shock (Septic & others)

4. By The End of The Talk Respiratory illnesses  Asthma, Respiratory failure & VTE CNS  CVA & Cerebral venous thrombosis Surgery / Trauma  how pregnancy change manifestation

5. Incidence & Outcomes Retrospective study Jan 1998  Sept 2005 University affiliated hospital which provide antenatal care for 9000 pregnant annually Closed Medical- Surgical ICU with 24/7 maternal-fetal medicine coverage Rate of admission 699/100,000 deliveries Daniela chest March 20007

6. Incidence & Outcomes Most admissions were postpartum & for obstetrical reasons Mortality 18/161 (11%) Increased mortality correlates with multiple organ dysfunctions & ICH Daniela chest March 20007

12. Causes Of Arrest in Pregnant VTE Arrhythmia from valvular heart disease Preeclampsia / Eclampsia Amniotic fluid embolism Hemorrhage

13. CPR in Pregnant AHA  Same protocol Effect of 15-30 degree Left lateral decub position on minimizing aortocaval compression Kinsella Anasth 2003 & Rees Anasth 1998 No difference in energy requirement in DC Transthoracic impedance at term & 6-8 weeks postpartum was essentially similar Nanson Br Jr Anasthe 2001 Effect of postmortem C-section? Few case reports

14. Questions ?