Evidence mapPaperPMID 41753176Full record

ReviewJournal of clinical medicine2026

Advances and Challenges in Obstetric Intensive Care Medicine.

Antonio Braga, Helder Konrad De Melo, Gabriela Paiva, Gustavo Mourão Rodrigues, Gustavo Yano Callado, Edward Araujo Júnior, Joffre Amim-Junior, Jorge de Rezende-Filho, Roberta Granese

Abstract readReview
In one paragraph

Review in Journal of clinical medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Antonio BragaDepartment of Gynecology and Obstetrics, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 22240-003, RJ, Brazil.ORCID 0000-0002-2942-6182
Helder Konrad De MeloIntensive Care Unit, Gloria D'or Hospital, Rede D'or, Rio de Janeiro 22211-230, RJ, Brazil.ORCID 0009-0007-0993-6912
Gabriela PaivaDepartment of Gynecology and Obstetrics, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 22240-003, RJ, Brazil.ORCID 0000-0003-3856-2116
Gustavo Mourão RodriguesDepartment of General and Specialized Surgery, School of Medicine and Surgery, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro 20271-062, RJ, Brazil.ORCID 0000-0002-5605-6658
Gustavo Yano CalladoDiscipline of Woman Health, Albert Einstein Israelite College of Health Sciences, Albert Einstein Israelite Hospital, São Paulo 05652-900, SP, Brazil.ORCID 0000-0001-6694-6569
Edward Araujo JúniorDiscipline of Woman Health, Municipal University of São Caetano do Sul (USCS), São Caetano do Sul 09521-160, SP, Brazil.ORCID 0000-0002-6145-2532
Joffre Amim-JuniorDepartment of Gynecology and Obstetrics, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 22240-003, RJ, Brazil.ORCID 0000-0001-9458-0584
Jorge de Rezende-FilhoDepartment of Gynecology and Obstetrics, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 22240-003, RJ, Brazil.ORCID 0000-0002-2193-3374
Roberta GraneseDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, "G. Martino" University Hospital, 98100 Messina, Italy.ORCID 0000-0003-0318-9390

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Obstetric critical care encompasses the management of pregnant and postpartum women with life-threatening conditions, requiring integration of intensive care principles with pregnancy-specific physiological, ethical, and organizational considerations. Although pregnancy is a physiological state, profound maternal adaptations may mask early signs of clinical deterioration, allowing rapid progression to a critical illness condition. This review provides a comprehensive overview of the foundations of obstetric intensive care, addressing maternal-fetal physiology, recognition of severity, organ support strategies, and contemporary models of care. Key aspects discussed include cardiovascular, respiratory, renal, and hematological adaptations of pregnancy; principles of airway management and mechanical ventilation; hemodynamic support; transfusion strategies guided by viscoelastic testing; renal replacement therapy; extracorporeal support, including extracorporeal membrane oxygenation and cardiopulmonary bypass; and the safe use of diagnostic imaging involving ionizing radiation. The role of point-of-care ultrasonography, structured early warning systems, and advanced monitoring in early detection and management of clinical deterioration is emphasized. Special attention is given to maternal-fetal interactions, fetal monitoring in the intensive care unit (ICU), and complex decision-making regarding timing and mode of delivery. The review also highlights the importance of multidisciplinary and multiprofessional collaboration, ethical challenges inherent to dual-patient care, and emerging strategies to expand access to specialized care, including tele-ICU models and artificial intelligence-assisted surveillance. Across all scenarios, maternal stabilization remains the primary determinant of fetal outcome. A structured approach grounded in maternal-fetal physiology and ethical principles is essential to reduce preventable maternal and perinatal morbidity and mortality in high-complexity settings.

Indexed as

intensive care unitmaternal–fetal physiologymultidisciplinary careobstetric critical caresevere maternal morbidity

Identifiers

PMID41753176
PMCPMC12941451

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.