The time is now: addressing the need for training in maternal critical care medicine. (May 2022)

• Record Type: Journal Article
• Authors: Padilla, C.; Zakowski, M.; Einav, S.; Weiniger, C.F.; Landau, R.; Chestnut, D.H.
• Is Part Of: International journal of obstetric anesthesia. Volume 50(2022)
• Publication Date: 2022-05
• Subjects: ACGME Accreditation Council for Graduate Medical Education -- ACSA Anaesthetists Anaesthesia Clinical Services Accreditation -- ACOG American College of Obstetricians and Gynecologists -- CCM critical care medicine -- SMFM Society for Maternal-Fetal Medicine -- OAA Obstetric Anaesthetists Association; Education -- Maternal critical care -- Maternal mortality -- Obstetric anesthesiology; Obstetrics -- Periodicals; Anesthesia -- Periodicals; Anesthésie en obstétrique -- Périodiques; Anesthesia; Obstetrics; Electronic journals; Periodicals; 617.9682
• DOI: 10.1016/j.ijoa.2022.103544
• Languages: English
• ISSNs: 0959-289X

Abstract

Highlights: Most maternal deaths in high income countries are due to indirect medical causes. Increased complexity of maternal illness contributes to indirect causes of deaths. Obstetric critical care education remains undefined and new models are required. Obstetric anesthesiologists can incorporate critical care skills in obstetric care. Dual obstetric anesthesiology/critical care fellowships might improve obstetric care. Abstract: Amongst many high-income countries, indirect medical conditions (e.g. cardiovascular disease, sepsis) now account for the majority of maternal deaths. In response to this concerning rise in indirect causes of maternal deaths, professional societies have developed guidelines that regionalize high-risk obstetric care and prioritize critical care expertise as a requirement for designated 'top' maternity hospitals. Critical care proficiency is mandated by the Accreditation Council for Graduate Medical Education for graduating obstetric anesthesiology fellows. Despite these requirements, no formal obstetric critical care educational curricula or fellowship pathways, combining critical care medicine and obstetric anesthesiology, currently exist. Dual subspecialty training in both obstetric anesthesiology and critical care medicine represents one strategy to improve the care of critically-ill obstetric patients and reduce maternal mortality and morbidity, which is one of the pressing healthcare issues of our time.