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The Medical City launches expanded maternal ICU

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Pregnancy and childbirth are major life events and all pregnancies involve a certain degree of risk to both mother and baby. While many pregnancies are without any complications, some encounter life-threatening events for the mother or for the fetus.

When critical complications arise during pregnancy, patients may need care from specialists in a health care facility that offers specialized, intensive care to ensure the best possible outcomes for mothers and babies alike.

The Medical City (TMC) is home to one of the country’s few maternal intensive care units that provides comprehensive high-risk perinatal services combined with holistic care by experienced, highly-skilled medical professionals.

The Medical City / Manila Bulletin

The Medical City / Manila Bulletin

TMC recently launched its expanded Maternal Intensive Care Unit (MICU) to accommodate more high-risk patients. Strategically located within the Delivery Suite, the MICU offers more privacy for the care of high-risk mothers and provides adequate space for the multidisciplinary team of experts so they can attend to their patients with ease. Maximizing TMC’s broad range of medical fields with the highest levels of expertise, MICU offers intensive monitoring of mother and baby in close coordination with other clinical departments, such as nursing, internal medicine, and surgery, among others.

Previously, the MICU could only accommodate up to two patients at a time. The new and enhanced MICU now has seven beds, each equipped with a continuous electronic fetal monitor connected to a central monitor, which allows close and strict antenatal surveillance.

Medical devices such as fetal heart rate monitoring devices, maternal vital signs monitors (for blood pressure, pulse, and other signs), and an ultrasound machine are ready for use when necessary. Other equipment such as infusion pumps, blood warmers, and blood filters are also available. The specialty beds have removable headboards and adjustable positions. Adequate lighting for bedside procedures, suction equipment and hypo/hyperthermia blankets are also readily available when needed.

Whether a pregnancy is considered high-risk due to hypertension or a heart condition, multiple births, diabetes and other endocrine disorders, or for any other reason, MICU’s

highly trained team works together to give the mother and baby the best care possible. The multidisciplinary team is usually composed of experts from Perinatology, Obstetrics and Gynecology, Neonatology, Obstetrical Anesthesia, Genetics, Internal Medicine, Surgery, Nursing, and Laboratory departments.

“Our goal at the Department of Obstetrics and Gynecology is to deliver the most comprehensive quality care for all mothers including high-risk pregnant mothers and their babies. The recent expansion of the MICU and the establishment of the High Risk Clinic will be crucial for us to attain this goal,” says Dr. Cecilia Vicencio, Chair of the TMC Department of Obstetrics and Gynecology.

“With our team of experienced and competent medical professionals, modern facilities, and advanced technology, we would like to reach more patients especially those needing our expertise in perinatal care,” adds Dr. Irene Quinio, Training Officer of the Section of Perinatology.

The MICU accepts patients with critical complications of pregnancy including hypertensive disorders, preterm labor, second and third trimester bleeding, disorders of the amniotic fluid, fetal growth restriction, and complicated multi-fetal pregnancies (discordant twins, one fetal-death-in-utero, and conjoined twins).

Expectant mothers with worsening or poor control of medical conditions but not requiring intensive care at the Adult ICU are also eligible for MICU admission. These medical conditions include diabetes mellitus, heart disease, bronchial asthma, chronic hypertensive vascular disease, hematologic and neurologic disorders, and maternal infections such as pneumonia, pyelonephritis, acute gastroenteritis, pulmonary tuberculosis.

Dr. Quinio adds that pregnant patients whose medical conditions are stable but the fetal condition is a priority are likewise admitted at the MICU.  An example is a mother with fetal heart rate abnormalities that warrant close fetal monitoring and may require immediate interventions and invasive procedures. These patients would benefit most from a referral to the Perinatology service.

Other conditions requiring admission to the MICU include post-operative pregnant patients with stable hemodynamic status; those with multiple injuries but with stable cardiorespiratory and hemodynamic status; those with toxic ingestion and drug overdose but with no threat of acute decompensation of major organ systems; and severely-ill pregnant patients who are ideally admitted in the Adult ICU but are in active labor.

In case there is a need for immediate delivery and the baby needs special attention, TMC also has a developmentally supportive, family-centered Neonatal Intensive Care Unit. This unit specializes in the care of critically ill or premature newborn infants and is staffed by competent neonatologists and other allied medical practitioners.

Outpatient continuity of care is provided to patients previously admitted to the MICU through the High Risk Clinic located in the Women’s Health Care Center. The High Risk Clinic is a venue for consultation with TMC’s Perinatologists who specialize in the care of high risk pregnancies.

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