UMEM Educational Pearls

Title: Ventilating the Obstetric Patient

Posted: 3/31/2009 by Mike Winters, MD (Updated: 4/1/2023)
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Mechanical Ventilation of the Obstetric Patient

In previous pearls, we have discussed ventilatory settings to avoid excessive volumes and limit plateau pressures to < 30 cm H₂O
Importantly, these settings have not be extensively evaluated in pregnant patients
Some important pearls when ventilating the pregnant patient:
- Avoid hyperventilation, as this adversely affects uterine blood flow
- Optimize oxygenation to ensure adequate fetal oxygen delivery (us 100% F_iO₂)
- In the presence of adequate oxygenation, P_aCO_s values <= 60 mm Hg do not appear to be detrimental to the fetus

References

Lapinsky SE, Posadas-Calleja JG, McCullagh I. Clinical review: Ventilator strategies for obstetric, brain-injured, and obese patients. Crit Care 2009;13:206.