Texas Children’s Hospital Creates ICU Specifically for Maternal-Fetal Medicine

The rate of maternal mortality in the United States is higher than that of any other developed country, and has even surpassed the rate in some developing nations (1). According to recent estimates, over 60 percent of maternal deaths could be prevented with proper medical care (2). Texas is an especially dangerous place to give birth; a USA Today investigation found that it has the seventh highest maternal death rate in the U.S. (3).

Texas Children’s Hospital is trying to change that. In January, they introduced a maternal intensive care unit (ICU), aimed at providing the best possible care to pregnant, laboring, and postpartum women who are experiencing a medical emergency.

“There are very few standalone OB critical care units that are dedicated just to taking care of mom and baby,” David Muigai, the medical director of the new maternal ICU, told TMC News (2).

Why is it so important to have a maternal ICU?

Women with high-risk pregnancies, as well as those who experience serious complications during labor, delivery, or the postpartum period, may need to spend time in an ICU. While an ICU may be the best place to receive certain forms of critical care, like pulmonary and cardiovascular support, the medical team may be less than fully prepared to handle obstetrical complications.

As Lynda Tyer-Viola (the vice president of Women’s Services and Professional Development and Research at Texas Children’s Pavilion for Women) explained to TMC News, “Women during pregnancy have varied, unique changes to their physiology related to how the heart works, how it pumps, the amount of blood volume they have in their body, when that volume will shif tyou need to know obstetrics and you need to know intensive care” (2).

About the maternal ICU

The new maternal ICU is housed within the labor and delivery unit at Texas Children’s Pavilion for Women. It contains four beds, and is staffed 24/7 by a team of medical professionals who specialize in pulmonary critical care, advanced cardiovascular life support, and maternal-fetal issues. In addition to having all of the technology in a typical ICU, the maternal ICU also has cutting-edge obstetrical equipment and fetal monitoring systems.

The maternal ICU accommodates women with conditions such as the following (among others):

Mugai commented that the maternal ICU has a different feel to it than a typical maternity ward.

“Before, people would walk into the labor and delivery unit and they were bumping into moms and dads who just had a baby, so they were very happy and walking up and down the hallway. In the middle of all that there is this really sick woman in this room, and sometimes it didn’t have the same gravitas,” he told TMC News. “I think having this location and having these services here, you can tell [the ICU staff] are feeling the depth, the gravity of the issue, as they come in through the doors.”

Despite having created some separation from the usually celebratory environment that is the maternity ward, they still want the maternal ICU to feel welcoming. “We expect and encourage families to stay with the patients,” said Tyer-Viola (2).

Broader impacts

In Texas, quality obstetrical care is often only available in large cities, with smaller community hospitals being ill-equipped to care for new mothers and babies. In 2013, the Texas Legislature passed a law requiring that all maternal care facilities be classified based on their ability to provide specific levels of care. As of September 2020, having a designated level of care will be a requirement for Medicaid reimbursement.

The rankings go from Level I (basic care) through Level IV (fully comprehensive care). Texas Children’s Pavilion for Women participated in a pilot project for determining levels of care, and has applied for a Level IV designation.

Additionally, the Pavilion for Women is a part of the TexasAIM initiative, which will help hospitals and clinics with projects that improve maternal safety and prevent maternal mortality and other serious complications. With the new maternal ICU, the Pavilion for Women has reduced the rate of serious obstetrical complications in patients, and is sharing their data and protocols with TexasAIM in the hope that it will help other hospitals do the same (2).

About ABC Law Centers

ABC Law Centers was established to focus exclusively on birth injury cases. A “birth injury” is any type of harm to a baby that occurs just before, during, or after birth. This includes issues such as oxygen deprivation, infection, and trauma. While some children with birth injuries make a complete recovery, others develop lifelong conditions such as cerebral palsy and intellectual disabilities.

If a birth injury/subsequent disability could have been prevented with proper care, then it constitutes medical malpractice. Settlements from birth injury cases can cover the costs of lifelong treatment, care, educational resources, and more.

If you believe you may have a birth injury case for your child, please contact us today to learn more. We are happy to talk to you free of any obligation or charge. In fact, clients pay nothing throughout the entire legal process unless we win.

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