Editors Manju Gita Mishra DGO MS FICS FICOG FIAMS FIMCH
Chairperson, Medical Education Committee FOGSI
Ex-Professor, Department of Obstetrics and Gynecology PMCH,
Patna
Chief Consultant, MGM Hospital,
Patna, India
Jyoti Sinha MBBS (Hons), DGO, MS (Obs/Gyne) PhD (Gyne oncology), FICOG
Director Professor Department of Obstetrics and Gynecology Shri Aurobindo Institute of Medical Sciences
Patna, India
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Critical Care in Obstetrics
© 2009, Federation of Obstetric and Gynaecological Societies of India (FOGSI)
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor and the publisher.
First Edition: 2009
9788184485479
Typeset at JPBMP typesetting unit
Printed at
5Contributors
- Alokendu Chatterjea frcog
- Former Prof and Head
- Dept of Obs and Gyne
- NRS Medical College, Kolkata
- President FOGSI 1999–2000
- Joydev Mukherji md
- Former Head, Dept of Obs and Gyne
- RG Kar Medical College, Kolkata
- Basab Mukherjee md, mrcog
- Consultant Gynecologist
- Kolkata
- Subrata Maitra md, mrcp
- Consultant Intensivist
- Belle Vue Clinic, Kolkata
- Sudip Chakravarti
- Prof, Obs and Gyne
- Vivekananda Institute of Medical Sciences
- 99 Sarat Bose Road, Kolkata
- Manju Gita Mishra dgo, ms, fics, ficog, fiams, fimch
- Chairperson, Medical Education Committee FOGSI
- Ex-Professor, Dept of Obs and Gyne
- PMCH, Patna
- Chief Consultant, MGM Hospital Patna, India
- Usha Sharma frcog (London)
- Consultant Obstetrician and Gynecologist
- SK Memorial and AK Memorial Hospital, Patna
- Kusum Gopal Kapoor ms, md, fics, ficog
- Ex-Prof and Head of the Dept of Obs and Gyne
- NMCH, Patna
- Mala Sinha ms (obs and gyne), ms (plastic surgery)
- Ex-HOD Plastic Surgery
- PMCH, Patna
- Gita Ganguly Mukherjee dgo, md, frcog
- Senior Consultant Gynecologist
- Former Prof and Head of Dept of Obs and Gyne
- RG Kar Medical College, Kolkata
- Mousumi De Banerjee dgo, dnb (g and o), mnams
- Consultant Gynecologist
- Kolkata
- Subhash Biswas md, ficog
- Associate Professor
- IPGMER
- Kolkata
- Basab Mukherjee md, mrcog
- Consultant Gynecologist
- Kolkata
- Pushpalatha
- Consultant Obstetrician and Gynecologist, Hyderabad
- Vice President: Indian Society of Perinatology and Reproductive Biology
- Past President: OGSH, APCOG
- Col R Puri md
- WHO Fellow (Materno Fetal Medicine)
- Gynecologist, Military Hospital
- Belgaum
- Narendra Malhotra md, ficog, ficmch
- Director, Malhotra and Maternity Home P (Ltd)
- Consultant Apollo Pankaj Hospital,
- Agra, India
- President FOGSI 2008
- Jaideep Malhotra md, ficog, ficmch
- Director
- Malhotra and Maternity Home P (Ltd)
- Consultant Apollo Pankaj Hospital,
- Agra, India
- Jyoti Sinha mbbs (hons), dgo, ms (obs/gyne) phd (gyne oncology), ficog
- Director Professor
- Dept of Obs and Gyne
- Shri Aurobindo Institute of Medical Sciences, Patna
- Smita Sinha mbbs, md
- Junior Consultant
- Obs and Gyne
- Malaysia
- Duru S Shah md, fcps, fics, ficog, dgo, dfp, ficmch
- Program Director, Melbourne IVF, Mumbai
- Hon Prof and Consultant Obstetrician and Gynecologist
- Breach Candy Hospital,
- Jaslok Hospital and Research Centre
- Sir HN Hospital and Research Centre,
- Mumbai
- Sukhpreet Patel md, dnb, fcps, dgo, pgdmls
- Ruxmani Lying in Hospital
- Bombay Hospital, Mumbai
- Rita Sinha
- Associate Professor
- Dept of Obs and Gyne
- PMCH, Patna
- SN Tripathy md, ficog
- Ex-Professor Obs and Gyne
- SCB Medical College
- Cuttack, Orissa
- Nirmala Saxena dgo, ms, frcog (london)
- Ex-Prof and HOD
- Nalanda Medical College Hospital
- Patna
- Pramila Modi md (obs and gyne)
- Consultant
- Modi Nursing Home, Patna
- Charu Modi dgo (dip in obs and gyne)
- Junior Consultant, Obs and Gyne
- Modi Nursing Home, Patna
- Neelam md, dgo, ficog
- Consultant Obs and Gyne
- Arvind Hospital
- Patna
- Shyam V Desai md, dgo, dfp, fcps, mnams
- Hon Prof N Wadia Hospital, Mumbai
- Payal Lakhani md, dnb
- Lecturer N Wadia Hospital
- Mumbai
- Neelu Soni
- Sr Consultant
- Obstetrician and Gynecologist
- Choithram Hospital and Research Centre
- Indore
- Sushma Jhamad
- Clinical Assistant
- Choitram Hospital and Research Centre
- Indore
- Sushma Singh dgo, ms (obs and gyne)
- Assistant Professor
- Dept of Obs and Gyne
- Katihar Medical College and Hospital
- Katihar, Bihar
- Abha Rani Sinha dgo, ms (obs and gyne)
- Assistant Professor
- Dept of Obs and Gyne
- Patna Medical College, Patna
- Shanti HK Singh ms (obs and gyne), ficoh, ficmch
- Retd Associate Professor
- Dept of Obs and Gyne
- Patna Medical College, Patna
- BB Das md
- All India Institute of Medical Sciences
- New Delhi, India
- A Kriplani
- Professor
- All India Institute of Medical Sciences
- New Delhi, India
- Dilip Kumar Dutta md, mams, ficog, ficmch
- Consultant Gynecologist
- Global Institute of Gynecology
- Kalyani Nadia, WB
- Indranil Dutta
- IIIrd year Medical Student
- JJM Medical College
- Davangere, Karnataka
- Sobha Chakraborty md (obs and gyne)
- Retired Professor
- Ranchi Medical College Hospital
- Ranchi
- Jagdishwari Mishra dgo, md, ms, frcog, ficog
- Ex-Professor and Head of Dept, Obs and Gyne
- Patna Medical College, Patna
- Chief Consultant, JM Maternity and Child Welfare Clinic and Research Centre
- Budha Colony, Patna
- Sumana G
- Senior Research Associate
- Dept of Obs and Gyne
- All India Institute of Medical Sciences
- New Delhi, India
- Vatsla Dadhwal
- Associate Professor
- Dept of Obs and Gyne
- All India Institute of Medical Sciences
- New Delhi, India
- Deepika Deka
- Professor, Dept of Obs and Gyne
- All India Institute of Medical Sciences
- New Delhi, India
- Arun Kumar Thakur
- Prof of Pediatrics, Dept of Pediatrics
- Nalanda Medical College, Patna
- Arun Kumar ms (general surgery), mch pediatric surgery (aiims)
- Assistant Professor
- Katihar Medical College and Hospital
- Katihar, Bihar
- Rajeshwari Subramaniam
- HOD, Dept of Anesthesia
- AIIMS, New Delhi, India
- Rajendra Prasad md, da
- Assistant Professor, Dept of Anesthesiology and Critical Care
- Patna Medical College, Patna
- Suneeta Mittal
- Professor Head, Dept of Obs and Gyne
- All India Institute of Medical Sciences
- New Delhi, India
- Pakhee Aggarwal
- Postgraduate Student
- Maulana Azad Medical College
- New Delhi
Pregnant women present to the obstetrician first. So obstetrician many times find themselves with a critically ill pregnant women under their care. They are in a dilemma how to deal with these cases as traditionally, care of the critically ill is done by anesthetist and medical adventist.
The pregnancy induced maternal physiologic changes added together with pathophysiological changes of critical illness that makes their management extremely complex. Treating these rare emergencies is a challenge.
Critical Care in Obstetrics is an attempt to guide practising obstetricians to deal with these emergencies.
This book also deals with care of the fetus in a critically ill gravida as well as care of baby born to critically ill mothers.
Special attention has been given to anesthetic management of critically ill obstetric patient and procedures such as airway and ventilation.
We hope this book shall be of assistance to all of you who handle obstetrical emergency unit.
Manju Gita Mishra
Jyoti Sinha