Parturient with Endocrine Disorders in the Intensive Care Unit

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Critical Care Medicine

Background:

• Pregnancy profoundly affects endocrine function, complicating the diagnosis of endocrine emergencies.
• Classical symptoms of endocrine disorders are often masked during pregnancy, posing diagnostic challenges.

Purpose of the Study:

• To review endocrine disorders in pregnant patients admitted to the Intensive Care Unit.
• To highlight diagnostic challenges and management strategies for endocrine emergencies during pregnancy.

Main Methods:

• Literature review focusing on endocrine disorders in pregnancy.
• Discussion of diagnostic tools like the Burch and Wartofsky scoring system for thyroid storm.
• Analysis of specific endocrine conditions: thyroid storm, myxedema coma, diabetic ketoacidosis, prolactinomas, adrenal insufficiency, and pheochromocytoma.

Main Results:

• Thyroid storm affects 0.1-0.4% of pregnancies; myxedema coma has a 20% mortality rate.
• Diabetic ketoacidosis risks fetal loss (10-25%); prolactinoma size increases during pregnancy.
• Unrecognized pheochromocytoma carries a 50% maternal mortality rate.

Conclusions:

• Effective management of endocrine disorders in pregnancy requires a multidisciplinary approach.
• Close collaboration between critical care, anesthesiology, obstetrics, and endocrinology is vital.
• Shared decision-making ensures optimal maternal and fetal outcomes in critical endocrine conditions during pregnancy.