Critical Care

A system of critical care requires physical space, technology for organ support and monitoring, a trained and interdisciplinary work force, and specific services it can deliver, both within the hospital and as a component in a larger healthcare system. In addition to individual patient-care services, it provides research, professional education, and disaster response. When planning obstetric critical care services, the intermediate care unit is a good approximation of the type and acuity of services generally needed. However, experience in 2009–2010 with novel influenza and most recently in 2019–2020 with SARS Co-V2 should remind us that pregnant women are at higher risk of respiratory failure in some circumstances. The director of obstetric services is a board-certified maternal-fetal medicine subspecialist or a board-certified obstetrician-gynecologist with expertise in critical care obstetrics. Advantages of vaginal delivery in intensive care unit include ready availability of critical care interventions and staff, plus avoidance of potentially destabilizing transport.