Luis D. Pacheco, MD, is Professor in the Department of Obstetrics and Gynecology and Anesthesiology and Division Chief of Obstetrics and Maternal Fetal Medicine, University of Texas Medical Branch, Galveston. He is board certified in critical care medicine. Jeffrey P. Phelan, MD, is a Maternal-Fetal Medicine specialist and Obstetrician-Gynecologist in West Covina, California, and holds positions at multiple area hospitals. He has over 35 years of clinical experience in the practice of Maternal-Fetal Medicine and in the area of Critical Care OB. Of note, Dr. Phelan has served as an editor and author on all prior editions of Critical Care OB. Torre L. Halscott MD, MS, is an Assistant Professor in the Department of Obstetrics and Gynecology and medical director of the Nelson Obsterical Clinic. Johns Hopkins University School of Medicine. He is board certified in critical care medicine. Leslie A. Moroz MD, MS, is an Assistant Professor in the Department of Obstetrics and Gynecology, Yale School of Medicine. She is board certified in critical care medicine. Arthur J. Vaught, MD, is an Associate Professor in the Department of Obstetrics and Gynecology and Surgery. He is the Director of Labor and Delivery and of the Advanced Obstetric Surgery Center. Johns Hopkins University, Baltimore, Maryland. He is board certified in critical care medicine. Antonio F. Saad, Professor at the Department of Obstetrics and Gynecology Director of Perinatal Research Unit And MFM Fellowship, Inova Health, Inova Fairfax Medical Campus. Amir A. Shamshirsaz, MD, is an Assistant Professor in the Department of Obstetrics and Gynecology and Medicine, Texas Children’s Hospital/Pavillion for Women and Baylor St. Luke’s Medical Center. He is board certified in critical care medicine.

• Notes on Contributors ixForeword xviiPreface xixPart One Basic Critical Care Clinical and Surgical Principles 11 Epidemiology of Critical Illness in Pregnancy 3Cande V. Ananth and John C. Smulian2 Organizing an Obstetrical Critical Care Unit: Care without Walls 17Lilly Y. Liu and Leslie Moroz3 Critical Care Obstetric Nursing 33Nan H. Troiano and Suzanne McMurtry Baird4 Pregnancy-Induced Physiologic Alterations 49Julian N. Robinson and Jeffrey P. Phelan5 Maternal Blood Gas Physiology 77Aaron B. Caughey6 Fluid and Electrolyte Balance 95William E. Scorza and Sharon Maynard7 Interventional Radiology in Pregnancy 123Arsalan Saleem, Sania Javed, Irfan Masood, and Eric M. Walser8 Fetal Considerations in the Critically Ill Gravida 133Jeffrey P. Phelan9 Fetal Effects of Drugs Commonly Used in Critical Care 163Anthony Kendle and Sarah Gloria Običan10 Maternal–Fetal Oxygenation 189Alfred D. Fleming and Marsha Henn11 Cardiopulmonary Resuscitation (CPR) in Pregnancy 199Terri–Ann Bennett and Carolyn M. Zelop12 Neonatal Resuscitation in the Critical Care Setting 209Jay P. Goldsmith and Gilbert I. Martin13 Ventilator Management in Critical Illness 233Luis D. Pacheco and Antonio F. Saad14 Vascular Access 267Eryn Hart, Gayle Olson, and Aristides P. Koutrouvelis15 Nutritional Support 283Bill Tang, Michael J. Tang, and Jeffrey P. Phelan16 Acute Kidney Injury and Renal Replacement Therapy 291Luis D. Pacheco and Chasey I. Omere17 Cardiopulmonary Bypass 305Erin G. Sreshta, Tris M. Miller, and Alexis L. McQuitty18 ECMO in Obstetrics 323Emily E. Naoum, Amir A. Shamshirsaz, and Luis D. Pacheco19 Antibiotics, Antivirals, and Antifungals in Critical Care 335Amir A. Shamshirsaz and Arthur J. Vaught20 Noninvasive Monitoring in Critical Care 361Sarah Rae Easter21 Critical Care Drills in Obstetrics 381Monica A. Lutgendorf and Shad H. Deering22 Maternal–Fetal Transport in the High-Risk Pregnancy 397Joshua A. Makhoul, Albert P. Sarno, Jr., and John C. SmulianPart Two Acute Emergencies 41123 Seizure and Status Epilepticus 413Amir Arain and Michael W. Varner24 Acute Spinal Cord Injury 423Lisa R. Wenzel, Angela Vrooman, and Hunter Hammill25 Severe Acute Asthma 443Dharani K. Narendra and Nicola A. Hanania26 Acute Respiratory Distress Syndrome in Pregnancy 455Dharani K. Narendra, Munish Sharma, David Muigai, and Kalpalatha K. Guntupalli27 The Acute Abdomen During Pregnancy 475Ibrahim A. Hammad28 Acute Pancreatitis 487Anna S. Leung and Jeffrey P. Phelan29 Pneumonia During Pregnancy (Bacterial and Viral) 503M. Ashley Cain and Judette M. Louis30 Acute Fatty Liver of Pregnancy 519Ibrahim A. Hammad and T. Flint Porter31 Disseminated Intravascular Coagulation 527Martina Burn, Hillary Hosier, Nazli Hossain, and Michael J. Paidas32 Endocrine Emergencies 541Mary C. Tolcher, Heather S. Hoff, Kjersti M. Aagaard, and Jeffrey P. Phelan33 Acute Psychiatric Conditions in Pregnancy: Critical Care Obstetrics 555Kelly B. Zafman and Adina R. Kern-Goldberger34 Diabetic Ketoacidosis 571Mark A. CurranPart Three Shock in Pregnancy 58535 Hypovolemic Shock 587Jerasimos Ballas and Scott Roberts36 Blood Component Therapy and Massive Transfusion 603Shiu-Ki R. Hui, Kjersti M. Aagaard, and Jun Teruya37 Etiology and Management of Hemorrhage (Includes Accreta) 627Irene A. Stafford, Karin A. Fox, Michael A. Belfort, and Gary A. Dildy38 Septic Shock 665Sonya S. Abdel-Razeq39 Cardiogenic Shock 697Martha W. F. Rac and Mary C. Tolcher40 Anaphylactic Shock in Pregnancy 707Richard Burwick41 Amniotic Fluid Embolism 719Gary A. Dildy, Michael A. Belfort, and Steven L. ClarkPart Four Medical/Surgical Management 73742 Pregnancy-Related Stroke 739Loralei L. Thornburg, Jamil ElFarra, and James N. Martin, Jr.43 Cardiac Disease and Pregnancy 775Abby Frederickson, Jordan D. Awerbach, Roxann Rokey, Michael A. Belfort, and Wayne J. Franklin44 Anesthesia Considerations for the Critically Ill Gravida with Cardiac Disease 813Yi Deng, Sanjna Tripathy, Lisa Mouzi Wofford, Vibha Mahendra, and Shoba Murugan45 Thromboembolic Disease 831Martha Pritchett Mims and Arthur J. Vaught46 Pulmonary Hypertension in Pregnancy 849Mohammad Zaidan and Alexander G. Duarte47 Sickle Cell Disease and Pregnancy 869Mark M. Udden and Iberia Romina Sosa48 Thrombotic Thrombocytopenic Purpura, Hemolytic–Uremic Syndrome, and HELLP 883Kelty R. Baker49 Complications of Preeclampsia 901Mary C. Tolcher and Kjersti M. Aagaard50 Systemic Lupus Erythematosus and Antiphospholipid Syndrome 939Fawzi Saoud and Maged M. Costantine51 Trauma in Pregnancy 959Robert Rossi, Alfredo F. Gei, Arthur J. Vaught, and James W. Van Hook52 Thermal and Electrical Injury 987Cornelia R. Graves53 Overdose, Poisoning, and Envenomation during Pregnancy 995Alfredo F. Gei, Victor R. Suarez, Arthur J. Vaught, and James W. Van Hook54 The Organ Transplant Patient in the Obstetric Critical Care Setting 1053Calla Holmgren and James Scott55 Fetal Surgery Procedures and Associated Maternal Complications 1065Eyal Krispin, Amir A. Shamshirsaz, Ahmed A. Nass, and Alireza A. Shamshirsaz56 Cancer in the Pregnant Patient 1075Kristin Bixel, Kenneth H. Kim, and David M. O’Malley57 Mass Casualties and the Obstetrical Patient 1093Lisa M. Foglia and Peter E. Nielson58 Biological, Chemical, and Radiological Exposures in Pregnancy 1099Lisa M. Foglia and Peter E. NielsonPart Five Ethical and Legal Considerations 110959 Ethics in the Obstetric Critical Care Setting 1111Fidelma B. Rigby60 Medical–Legal Considerations in Critical Care Obstetrics 1137Jeffrey P. PhelanIndex 1161

Luis D. Pacheco, MD, is Professor in the Department of Obstetrics and Gynecology and Anesthesiology and Division Chief of Obstetrics and Maternal Fetal Medicine, University of Texas Medical Branch, Galveston. He is board certified in critical care medicine. Jeffrey P. Phelan, MD, is a Maternal-Fetal Medicine specialist and Obstetrician-Gynecologist in West Covina, California, and holds positions at multiple area hospitals. He has over 35 years of clinical experience in the practice of Maternal-Fetal Medicine and in the area of Critical Care OB. Of note, Dr. Phelan has served as an editor and author on all prior editions of Critical Care OB. Torre L. Halscott MD, MS, is an Assistant Professor in the Department of Obstetrics and Gynecology and medical director of the Nelson Obsterical Clinic. Johns Hopkins University School of Medicine. He is board certified in critical care medicine. Leslie A. Moroz MD, MS, is an Assistant Professor in the Department of Obstetrics and Gynecology, Yale School of Medicine. She is board certified in critical care medicine. Arthur J. Vaught, MD, is an Associate Professor in the Department of Obstetrics and Gynecology and Surgery. He is the Director of Labor and Delivery and of the Advanced Obstetric Surgery Center. Johns Hopkins University, Baltimore, Maryland. He is board certified in critical care medicine. Antonio F. Saad, Professor at the Department of Obstetrics and Gynecology Director of Perinatal Research Unit And MFM Fellowship, Inova Health, Inova Fairfax Medical Campus. Amir A. Shamshirsaz, MD, is an Assistant Professor in the Department of Obstetrics and Gynecology and Medicine, Texas Children’s Hospital/Pavillion for Women and Baylor St. Luke’s Medical Center. He is board certified in critical care medicine.

• Notes on Contributors ixForeword xviiPreface xixPart One Basic Critical Care Clinical and Surgical Principles 11 Epidemiology of Critical Illness in Pregnancy 3Cande V. Ananth and John C. Smulian2 Organizing an Obstetrical Critical Care Unit: Care without Walls 17Lilly Y. Liu and Leslie Moroz3 Critical Care Obstetric Nursing 33Nan H. Troiano and Suzanne McMurtry Baird4 Pregnancy-Induced Physiologic Alterations 49Julian N. Robinson and Jeffrey P. Phelan5 Maternal Blood Gas Physiology 77Aaron B. Caughey6 Fluid and Electrolyte Balance 95William E. Scorza and Sharon Maynard7 Interventional Radiology in Pregnancy 123Arsalan Saleem, Sania Javed, Irfan Masood, and Eric M. Walser8 Fetal Considerations in the Critically Ill Gravida 133Jeffrey P. Phelan9 Fetal Effects of Drugs Commonly Used in Critical Care 163Anthony Kendle and Sarah Gloria Običan10 Maternal–Fetal Oxygenation 189Alfred D. Fleming and Marsha Henn11 Cardiopulmonary Resuscitation (CPR) in Pregnancy 199Terri–Ann Bennett and Carolyn M. Zelop12 Neonatal Resuscitation in the Critical Care Setting 209Jay P. Goldsmith and Gilbert I. Martin13 Ventilator Management in Critical Illness 233Luis D. Pacheco and Antonio F. Saad14 Vascular Access 267Eryn Hart, Gayle Olson, and Aristides P. Koutrouvelis15 Nutritional Support 283Bill Tang, Michael J. Tang, and Jeffrey P. Phelan16 Acute Kidney Injury and Renal Replacement Therapy 291Luis D. Pacheco and Chasey I. Omere17 Cardiopulmonary Bypass 305Erin G. Sreshta, Tris M. Miller, and Alexis L. McQuitty18 ECMO in Obstetrics 323Emily E. Naoum, Amir A. Shamshirsaz, and Luis D. Pacheco19 Antibiotics, Antivirals, and Antifungals in Critical Care 335Amir A. Shamshirsaz and Arthur J. Vaught20 Noninvasive Monitoring in Critical Care 361Sarah Rae Easter21 Critical Care Drills in Obstetrics 381Monica A. Lutgendorf and Shad H. Deering22 Maternal–Fetal Transport in the High-Risk Pregnancy 397Joshua A. Makhoul, Albert P. Sarno, Jr., and John C. SmulianPart Two Acute Emergencies 41123 Seizure and Status Epilepticus 413Amir Arain and Michael W. Varner24 Acute Spinal Cord Injury 423Lisa R. Wenzel, Angela Vrooman, and Hunter Hammill25 Severe Acute Asthma 443Dharani K. Narendra and Nicola A. Hanania26 Acute Respiratory Distress Syndrome in Pregnancy 455Dharani K. Narendra, Munish Sharma, David Muigai, and Kalpalatha K. Guntupalli27 The Acute Abdomen During Pregnancy 475Ibrahim A. Hammad28 Acute Pancreatitis 487Anna S. Leung and Jeffrey P. Phelan29 Pneumonia During Pregnancy (Bacterial and Viral) 503M. Ashley Cain and Judette M. Louis30 Acute Fatty Liver of Pregnancy 519Ibrahim A. Hammad and T. Flint Porter31 Disseminated Intravascular Coagulation 527Martina Burn, Hillary Hosier, Nazli Hossain, and Michael J. Paidas32 Endocrine Emergencies 541Mary C. Tolcher, Heather S. Hoff, Kjersti M. Aagaard, and Jeffrey P. Phelan33 Acute Psychiatric Conditions in Pregnancy: Critical Care Obstetrics 555Kelly B. Zafman and Adina R. Kern-Goldberger34 Diabetic Ketoacidosis 571Mark A. CurranPart Three Shock in Pregnancy 58535 Hypovolemic Shock 587Jerasimos Ballas and Scott Roberts36 Blood Component Therapy and Massive Transfusion 603Shiu-Ki R. Hui, Kjersti M. Aagaard, and Jun Teruya37 Etiology and Management of Hemorrhage (Includes Accreta) 627Irene A. Stafford, Karin A. Fox, Michael A. Belfort, and Gary A. Dildy38 Septic Shock 665Sonya S. Abdel-Razeq39 Cardiogenic Shock 697Martha W. F. Rac and Mary C. Tolcher40 Anaphylactic Shock in Pregnancy 707Richard Burwick41 Amniotic Fluid Embolism 719Gary A. Dildy, Michael A. Belfort, and Steven L. ClarkPart Four Medical/Surgical Management 73742 Pregnancy-Related Stroke 739Loralei L. Thornburg, Jamil ElFarra, and James N. Martin, Jr.43 Cardiac Disease and Pregnancy 775Abby Frederickson, Jordan D. Awerbach, Roxann Rokey, Michael A. Belfort, and Wayne J. Franklin44 Anesthesia Considerations for the Critically Ill Gravida with Cardiac Disease 813Yi Deng, Sanjna Tripathy, Lisa Mouzi Wofford, Vibha Mahendra, and Shoba Murugan45 Thromboembolic Disease 831Martha Pritchett Mims and Arthur J. Vaught46 Pulmonary Hypertension in Pregnancy 849Mohammad Zaidan and Alexander G. Duarte47 Sickle Cell Disease and Pregnancy 869Mark M. Udden and Iberia Romina Sosa48 Thrombotic Thrombocytopenic Purpura, Hemolytic–Uremic Syndrome, and HELLP 883Kelty R. Baker49 Complications of Preeclampsia 901Mary C. Tolcher and Kjersti M. Aagaard50 Systemic Lupus Erythematosus and Antiphospholipid Syndrome 939Fawzi Saoud and Maged M. Costantine51 Trauma in Pregnancy 959Robert Rossi, Alfredo F. Gei, Arthur J. Vaught, and James W. Van Hook52 Thermal and Electrical Injury 987Cornelia R. Graves53 Overdose, Poisoning, and Envenomation during Pregnancy 995Alfredo F. Gei, Victor R. Suarez, Arthur J. Vaught, and James W. Van Hook54 The Organ Transplant Patient in the Obstetric Critical Care Setting 1053Calla Holmgren and James Scott55 Fetal Surgery Procedures and Associated Maternal Complications 1065Eyal Krispin, Amir A. Shamshirsaz, Ahmed A. Nass, and Alireza A. Shamshirsaz56 Cancer in the Pregnant Patient 1075Kristin Bixel, Kenneth H. Kim, and David M. O’Malley57 Mass Casualties and the Obstetrical Patient 1093Lisa M. Foglia and Peter E. Nielson58 Biological, Chemical, and Radiological Exposures in Pregnancy 1099Lisa M. Foglia and Peter E. NielsonPart Five Ethical and Legal Considerations 110959 Ethics in the Obstetric Critical Care Setting 1111Fidelma B. Rigby60 Medical–Legal Considerations in Critical Care Obstetrics 1137Jeffrey P. PhelanIndex 1161

Luis D. Pacheco, MD, is Professor in the Department of Obstetrics and Gynecology and Anesthesiology and Division Chief of Obstetrics and Maternal Fetal Medicine, University of Texas Medical Branch, Galveston. He is board certified in critical care medicine. Jeffrey P. Phelan, MD, is a Maternal-Fetal Medicine specialist and Obstetrician-Gynecologist in West Covina, California, and holds positions at multiple area hospitals. He has over 35 years of clinical experience in the practice of Maternal-Fetal Medicine and in the area of Critical Care OB. Of note, Dr. Phelan has served as an editor and author on all prior editions of Critical Care OB. Torre L. Halscott MD, MS, is an Assistant Professor in the Department of Obstetrics and Gynecology and medical director of the Nelson Obsterical Clinic. Johns Hopkins University School of Medicine. He is board certified in critical care medicine. Leslie A. Moroz MD, MS, is an Assistant Professor in the Department of Obstetrics and Gynecology, Yale School of Medicine. She is board certified in critical care medicine. Arthur J. Vaught, MD, is an Associate Professor in the Department of Obstetrics and Gynecology and Surgery. He is the Director of Labor and Delivery and of the Advanced Obstetric Surgery Center. Johns Hopkins University, Baltimore, Maryland. He is board certified in critical care medicine. Antonio F. Saad, Professor at the Department of Obstetrics and Gynecology Director of Perinatal Research Unit And MFM Fellowship, Inova Health, Inova Fairfax Medical Campus. Amir A. Shamshirsaz, MD, is an Assistant Professor in the Department of Obstetrics and Gynecology and Medicine, Texas Children’s Hospital/Pavillion for Women and Baylor St. Luke’s Medical Center. He is board certified in critical care medicine.

• Notes on Contributors ixForeword xviiPreface xixPart One Basic Critical Care Clinical and Surgical Principles 11 Epidemiology of Critical Illness in Pregnancy 3Cande V. Ananth and John C. Smulian2 Organizing an Obstetrical Critical Care Unit: Care without Walls 17Lilly Y. Liu and Leslie Moroz3 Critical Care Obstetric Nursing 33Nan H. Troiano and Suzanne McMurtry Baird4 Pregnancy-Induced Physiologic Alterations 49Julian N. Robinson and Jeffrey P. Phelan5 Maternal Blood Gas Physiology 77Aaron B. Caughey6 Fluid and Electrolyte Balance 95William E. Scorza and Sharon Maynard7 Interventional Radiology in Pregnancy 123Arsalan Saleem, Sania Javed, Irfan Masood, and Eric M. Walser8 Fetal Considerations in the Critically Ill Gravida 133Jeffrey P. Phelan9 Fetal Effects of Drugs Commonly Used in Critical Care 163Anthony Kendle and Sarah Gloria Običan10 Maternal–Fetal Oxygenation 189Alfred D. Fleming and Marsha Henn11 Cardiopulmonary Resuscitation (CPR) in Pregnancy 199Terri–Ann Bennett and Carolyn M. Zelop12 Neonatal Resuscitation in the Critical Care Setting 209Jay P. Goldsmith and Gilbert I. Martin13 Ventilator Management in Critical Illness 233Luis D. Pacheco and Antonio F. Saad14 Vascular Access 267Eryn Hart, Gayle Olson, and Aristides P. Koutrouvelis15 Nutritional Support 283Bill Tang, Michael J. Tang, and Jeffrey P. Phelan16 Acute Kidney Injury and Renal Replacement Therapy 291Luis D. Pacheco and Chasey I. Omere17 Cardiopulmonary Bypass 305Erin G. Sreshta, Tris M. Miller, and Alexis L. McQuitty18 ECMO in Obstetrics 323Emily E. Naoum, Amir A. Shamshirsaz, and Luis D. Pacheco19 Antibiotics, Antivirals, and Antifungals in Critical Care 335Amir A. Shamshirsaz and Arthur J. Vaught20 Noninvasive Monitoring in Critical Care 361Sarah Rae Easter21 Critical Care Drills in Obstetrics 381Monica A. Lutgendorf and Shad H. Deering22 Maternal–Fetal Transport in the High-Risk Pregnancy 397Joshua A. Makhoul, Albert P. Sarno, Jr., and John C. SmulianPart Two Acute Emergencies 41123 Seizure and Status Epilepticus 413Amir Arain and Michael W. Varner24 Acute Spinal Cord Injury 423Lisa R. Wenzel, Angela Vrooman, and Hunter Hammill25 Severe Acute Asthma 443Dharani K. Narendra and Nicola A. Hanania26 Acute Respiratory Distress Syndrome in Pregnancy 455Dharani K. Narendra, Munish Sharma, David Muigai, and Kalpalatha K. Guntupalli27 The Acute Abdomen During Pregnancy 475Ibrahim A. Hammad28 Acute Pancreatitis 487Anna S. Leung and Jeffrey P. Phelan29 Pneumonia During Pregnancy (Bacterial and Viral) 503M. Ashley Cain and Judette M. Louis30 Acute Fatty Liver of Pregnancy 519Ibrahim A. Hammad and T. Flint Porter31 Disseminated Intravascular Coagulation 527Martina Burn, Hillary Hosier, Nazli Hossain, and Michael J. Paidas32 Endocrine Emergencies 541Mary C. Tolcher, Heather S. Hoff, Kjersti M. Aagaard, and Jeffrey P. Phelan33 Acute Psychiatric Conditions in Pregnancy: Critical Care Obstetrics 555Kelly B. Zafman and Adina R. Kern-Goldberger34 Diabetic Ketoacidosis 571Mark A. CurranPart Three Shock in Pregnancy 58535 Hypovolemic Shock 587Jerasimos Ballas and Scott Roberts36 Blood Component Therapy and Massive Transfusion 603Shiu-Ki R. Hui, Kjersti M. Aagaard, and Jun Teruya37 Etiology and Management of Hemorrhage (Includes Accreta) 627Irene A. Stafford, Karin A. Fox, Michael A. Belfort, and Gary A. Dildy38 Septic Shock 665Sonya S. Abdel-Razeq39 Cardiogenic Shock 697Martha W. F. Rac and Mary C. Tolcher40 Anaphylactic Shock in Pregnancy 707Richard Burwick41 Amniotic Fluid Embolism 719Gary A. Dildy, Michael A. Belfort, and Steven L. ClarkPart Four Medical/Surgical Management 73742 Pregnancy-Related Stroke 739Loralei L. Thornburg, Jamil ElFarra, and James N. Martin, Jr.43 Cardiac Disease and Pregnancy 775Abby Frederickson, Jordan D. Awerbach, Roxann Rokey, Michael A. Belfort, and Wayne J. Franklin44 Anesthesia Considerations for the Critically Ill Gravida with Cardiac Disease 813Yi Deng, Sanjna Tripathy, Lisa Mouzi Wofford, Vibha Mahendra, and Shoba Murugan45 Thromboembolic Disease 831Martha Pritchett Mims and Arthur J. Vaught46 Pulmonary Hypertension in Pregnancy 849Mohammad Zaidan and Alexander G. Duarte47 Sickle Cell Disease and Pregnancy 869Mark M. Udden and Iberia Romina Sosa48 Thrombotic Thrombocytopenic Purpura, Hemolytic–Uremic Syndrome, and HELLP 883Kelty R. Baker49 Complications of Preeclampsia 901Mary C. Tolcher and Kjersti M. Aagaard50 Systemic Lupus Erythematosus and Antiphospholipid Syndrome 939Fawzi Saoud and Maged M. Costantine51 Trauma in Pregnancy 959Robert Rossi, Alfredo F. Gei, Arthur J. Vaught, and James W. Van Hook52 Thermal and Electrical Injury 987Cornelia R. Graves53 Overdose, Poisoning, and Envenomation during Pregnancy 995Alfredo F. Gei, Victor R. Suarez, Arthur J. Vaught, and James W. Van Hook54 The Organ Transplant Patient in the Obstetric Critical Care Setting 1053Calla Holmgren and James Scott55 Fetal Surgery Procedures and Associated Maternal Complications 1065Eyal Krispin, Amir A. Shamshirsaz, Ahmed A. Nass, and Alireza A. Shamshirsaz56 Cancer in the Pregnant Patient 1075Kristin Bixel, Kenneth H. Kim, and David M. O’Malley57 Mass Casualties and the Obstetrical Patient 1093Lisa M. Foglia and Peter E. Nielson58 Biological, Chemical, and Radiological Exposures in Pregnancy 1099Lisa M. Foglia and Peter E. NielsonPart Five Ethical and Legal Considerations 110959 Ethics in the Obstetric Critical Care Setting 1111Fidelma B. Rigby60 Medical–Legal Considerations in Critical Care Obstetrics 1137Jeffrey P. PhelanIndex 1161