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Intra-abdominal pressure, intra-abdominal hypertension, and pregnancy: a review

Rosaleen Chun1, Andrew W Kirkpatrick

  • 1Department of Anesthesia, Foothills Medical Centre, University of Calgary, 1403-29th St, NW, Calgary, T2N 2T9, Canada. rosaleen.chun@albertahealthservices.ca.

Annals of Intensive Care
|August 10, 2012
PubMed

Insights

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognized, but their impact during pregnancy is overlooked. This review emphasizes the need for understanding intra-abdominal pressure (IAP) in critically ill pregnant patients.

Area of Science:

  • Critical care medicine
  • Obstetrics
  • Surgical critical care

Background:

  • Significant advancements in understanding abdominal compartment syndrome (ACS) and intra-abdominal hypertension (IAH) have occurred in critical care, trauma, and surgical fields.
  • The World Society of the Abdominal Compartment Syndrome (WSACS) has been established to further this knowledge.
  • However, the specific implications of intra-abdominal pressure (IAP), IAH, and ACS in pregnancy remain largely unaddressed.

Purpose of the Study:

  • To highlight the significance of intra-abdominal pressure (IAP) in critically ill pregnant patients (parturients).
  • To identify the current lack of established normative IAP values specific to pregnancy.
  • To explore the potential association between IAH and maternal conditions like preeclampsia-eclampsia, and its effects on fetal development.

Main Methods:

  • This is a review article, synthesizing existing knowledge and highlighting gaps in the literature.
  • It critically examines current guidelines for measuring IAP.
  • It specifically considers the mechanical impact of the gravid uterus on intra-vesicular pressure.

Main Results:

  • Intra-abdominal pressure (IAP) plays a crucial, yet underappreciated, role in the critically ill pregnant population.
  • There is a notable absence of normative intra-abdominal pressure (IAP) data for pregnant individuals.
  • Existing guidelines for IAP measurement may not accurately reflect the physiological changes in pregnancy due to the gravid uterus.

Conclusions:

  • Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are relevant in pregnancy and require further investigation.
  • Developing pregnancy-specific normative intra-abdominal pressure (IAP) values is essential.
  • Current IAP measurement protocols need revision to account for the gravid uterus's influence.

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