UMEM Educational Pearls

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% FiO2)
    • In the presence of adequate oxygenation, PaCOs values <= 60 mm Hg do not appear to be detrimental to the fetus


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