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Maternal-fetal assessment of the critically ill parturient: decisions related to delivery.

Preparation for delivery of the critically ill pregnant women begins soon after admission to the intensive care unit. Unless maternal or fetal condition deteriorates, remaining in utero may be more beneficial to the premature fetus. A decision regarding the timing of delivery is based on the impact on maternal and fetal well-being of maintaining the fetus in utero. Maternal or fetal instability may necessitate immediate delivery, and specialist from critical care, obstetrics, neonatology, and anesthesiology should decide on the most appropriate location for labor and delivery. Personnel from affected departments are alerted as soon as possible to facilitate the gathering of necessary equipment and supplies and the attendance of skilled professionals in intrapartum management and neonatal resuscitation.