Maternity Critical care (Joint session OAA)

Blogger Adrian Wong (@avkwong)

MBRACE – an update for intensivists

Nuala Lucas

Summary/Key messages

Mothers and Babies: Reducing Risks through Audits and Confidential Enquires across UK (MBRRACE-UK)

Evolution of the project; CEMACH –> CMACE –> MBRRACE

  • Now annual, rather than triennial,  with focused subjects and much greater emphasis on learning
  • Direct and indirect falling in number but more so with direct deaths.
  • Single biggest cause of death is cardiac
  • 42% of women had suboptimal care which may have contributed to her death
  • Women who died from sepsis had poor quality of care (63%)
  • Post-delivery dangerous period
  • Point-Of-Care testing is useful – Difficult to assess bleeding as women compensate well
  • Amniotic Fluid Embolus rates falling
  • Chest compression is difficult to perform effectively when the woman is being moved to theatre
  • Role for outreach to check on them and transfer team

References/Further reading

Equity of maternity critical care – new and improved!

Audrey Quinn

Summary/Key messages

IMG_6550

Maternity and critical care

Summary/Key messages

  • Rates of ICU admission have remained stable – haemorrhage main reason
  • Main challenges due to fragmented care –> NEED A LEAD CLINICIAN
  • Many conditions are rare: therefore no ‘expert’ but you need a single responsible physician
  • Increase cross-working between team needed; obstetricians doing ICU block and ICU doing obstetric (not anaesthetic) block

References/Further reading

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