Acute care toolkit 15: Managing acute medical problems in pregnancy

Pregnant women can present to any acute hospital service at any time during their pregnancy or the postpartum period, which is up to 12 months post-delivery.

Women may present with acute medical problems that need to be managed differently because of pregnancy, or may present with obstetric syndromes. Over two-thirds of all maternal deaths in the UK are due to non-obstetric, medical problems in pregnancy and postpartum.

This toolkit is essential reading for front-line NHS staff who may be unfamiliar with the normal physiology of pregnancy and/or diseases that present in pregnancy. Challenges arise in managing two lives — the mother and the baby — often leading to a state of clinical inertia.

The toolkit contains:

  • practical guidance on managing women with acute medical problems in pregnancy
  • red flags to watch out for in pregnant patients
  • advice to healthcare staff to ask about a woman’s mental wellbeing when she comes to hospital for other reasons during or after pregnancy
  • recommendations to improve the standard of acute care for pregnant women.

Further educational and quality improvement tools, including flowcharts for managing pregnant patients with a variety of symptoms, are available in the appendices.

Updated on 25 November 2019: please note that page 3 of the toolkit has been amended to reflect current guidance on codeine/opiates under the heading ‘Common medications used in acute medical conditions, and their use in pregnancy’. Flowchart 1a has also been updated.