Organizing an Obstetrical Critical Care Unit: Care without Walls

Intensive care unit (ICU) care is associated with invasive methods for monitoring vital status as well as invasive means of providing organ support. During the COVID-19 pandemic, the traditional ICU model was dramatically modified to meet the intensive care needs of the community, highlighting the importance of a multidisciplinary approach. Obstetricians and maternal-fetal medicine specialists should ensure that they are included in multispecialty collaborative rounds in the ICU, and intensivists should seek out input from obstetric specialists. Critical care management of the obstetric patient requires a multidisciplinary team with insight into the physiologic changes that occur in pregnancy and the impact on fetal well-being. Thromboelastography (TEG), or rotational thromboelastometry, are noninvasive diagnostic tools with increasing utility and benefit for the evaluation and correction of coagulopathy in the critically ill obstetric patient. TEG is able to detect and quantify the dynamic changes of the viscoelastic properties of a blood sample during clotting.