Management of meningitis in critical obstetric patients: a case report

Pregnancy is considered a relative immunology-compromising condition that increases the risk of severe infections, including meningitis. Pregnant women and fetuses who have invasive bacterial infections are far more likely to suffer substantial complications. Meningitis in critically ill pregnant women is a rare yet life-threatening condition that can develop rapidly, affecting both maternal and fetal well-being. Delayed recognition can lead to higher morbidity and mortality. We hereby present three cases of bacterial meningitis in pregnant Indonesian women referred to the Cipto Mangunkusumo Hospital Intensive Care Unit. This case report aims to analyze and compare the management of meningitis in critically ill obstetric patients.

All patients were Indonesian women aged 19, 27, and 29 years old; one patient was primigravida and two were multigravida, with gestational age of presentation ranging from 24 weeks to 30 weeks. One patient had early termination of pregnancy, one continued with the pregnancy, and one experienced intrauterine fetal death.

Our cases demonstrate the importance of resuscitation and therapeutic strategies on the basis of the stabilization of the mother's acute condition and the importance of a multidisciplinary approach.