{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T08:54:36Z","timestamp":1771145676907,"version":"3.50.1"},"reference-count":109,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Maternal mortality continues to be an issue globally despite advances in technology and pharmacotherapy. Pregnancy can lead to complications that necessitate immediate action to prevent severe morbidity and mortality. Patients may need escalation to the ICU setting for close monitoring and administration of advanced therapies not available elsewhere. Obstetric emergencies are rare but high\u2010stakes events that require clinicians to have prompt identification and management. The purpose of this review is to describe complications of pregnancy and provide a focused resource of pharmacotherapy considerations that clinicians may encounter. For each disease state, the epidemiology, pathophysiology, and management are summarized. Brief descriptions of non\u2010pharmacological (e.g., cesarean or vaginal delivery of the baby) interventions are provided. Mainstays of pharmacotherapy highlighted include oxytocin for obstetric hemorrhage, methotrexate for ectopic pregnancy, magnesium and antihypertensive agents for preeclampsia and eclampsia, eculizumab for atypical hemolytic uremic syndrome, corticosteroids, and immunosuppressive agents for thrombotic thrombocytopenic purpura, diuretics, metoprolol, and anticoagulation for peripartum cardiomyopathy, and pulmonary vasodilators for amniotic fluid embolism.<\/jats:p>","DOI":"10.1002\/phar.2837","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T01:41:41Z","timestamp":1686879701000},"page":"659-674","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Caring for two in the ICU: Pharmacologic management of pregnancy\u2010related complications"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3007-7685","authenticated-orcid":false,"given":"Mojdeh S.","family":"Heavner","sequence":"first","affiliation":[{"name":"University of Maryland School of Pharmacy  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5823-7495","authenticated-orcid":false,"given":"Michaelia D.","family":"Cucci","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Akron General  Akron Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5118-7029","authenticated-orcid":false,"given":"Brooke","family":"Barlow","sequence":"additional","affiliation":[{"name":"Memorial Hermann Woodlands Medical Center  Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7024-9934","authenticated-orcid":false,"given":"Carolyn Magee","family":"Bell","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5492-3802","authenticated-orcid":false,"given":"Claire C.","family":"Eng","sequence":"additional","affiliation":[{"name":"Memorial Hermann Sugar Land Hospital  Sugar Land Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Erdman","sequence":"additional","affiliation":[{"name":"University of Maryland Medical Center  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1320-7134","authenticated-orcid":false,"given":"Matthew","family":"Li","sequence":"additional","affiliation":[{"name":"Westchester Medical Center  Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5171-8405","authenticated-orcid":false,"given":"Susan E.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Georgia College of Pharmacy  Athens Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Aldhaeefi","sequence":"additional","affiliation":[{"name":"Clinical and Administrative Pharmacy Sciences, College of Pharmacy Howard University  Washington DC United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa L.","family":"Thompson\u00a0Bastin","sequence":"additional","affiliation":[{"name":"University of Kentucky HealthCare  Lexington Kentucky USA"},{"name":"University of Kentucky College of Pharmacy  Lexington Kentucky USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4083-7919","authenticated-orcid":false,"given":"W. Anthony","family":"Hawkins","sequence":"additional","affiliation":[{"name":"University of Georgia College of Pharmacy  Athens Georgia USA"},{"name":"Medical College of Georgia at Augusta University  Albany Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Rose","sequence":"additional","affiliation":[{"name":"Temple University School of Pharmacy  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Lankford","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31470-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0261974"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13241"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1Q532"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp170662"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03818-1"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002114"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2011.01303.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12873-017-0128-3"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1709324"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318262e340"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13547"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002351"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2010.01030.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14116"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.10.017"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2016.05.004"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.02.044"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000123245.48645.98"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1253057"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2017\/22659.9463"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2017.01.007"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199856040-00002"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen273"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f8930a"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000142709.04450.bd"},{"key":"e_1_2_11_28_1","unstructured":"Methergine [package insert].Novartis Pharmaceuticals Corp;2012."},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.09.004"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60348-0"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.05.008"},{"issue":"4","key":"e_1_2_11_32_1","first-page":"426","article-title":"Management of severe postpartum hemorrhage due to uterine atony using an analogue of prostaglandin F2 alpha","volume":"58","author":"Hayashi RH","year":"1981","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1521-6934(03)00043-9"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/0959-289X(94)90213-5"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.01.008"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.07.036"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30638-4"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.01.001"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002962"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16699"},{"issue":"10","key":"e_1_2_11_41_1","first-page":"599","article-title":"Ectopic pregnancy: diagnosis and management","volume":"101","author":"Hendriks E","year":"2020","journal-title":"Am Fam Physician"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002464"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.07.489"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2013.06.013"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/61.13.1380"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60279-6"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003892"},{"issue":"6","key":"e_1_2_11_48_1","first-page":"1070","article-title":"Aggressive or expectant management for patients with severe preeclampsia between 28\u201334\u2009weeks' gestation: a randomized controlled trial","volume":"76","author":"Odendaal HJ","year":"1990","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(94)90104-X"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002237"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001449.pub3"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000025"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000127.pub2"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021180"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08778-0"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200038040-00002"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13753"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1081\/PRG-120024029"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000235721.88349.80"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1998.tb10090.x"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70022-0"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.309.6966.1395"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002960.pub2"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91034-4"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(86)90805-7"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90996-K"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90376-I"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)91426-9"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008148.pub2"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020005221"},{"key":"e_1_2_11_71_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2015.1.644"},{"key":"e_1_2_11_72_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-02-408914"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-015-0557-5"},{"key":"e_1_2_11_74_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.111.223610"},{"issue":"9","key":"e_1_2_11_75_1","first-page":"1029","article-title":"Mild to moderate reduction of a von Willebrand factor cleaving protease (ADAMTS\u201013) in pregnant women with HELLP microangiopathic syndrome","volume":"88","author":"Lattuada A","year":"2003","journal-title":"Haematologica"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-02-553131"},{"key":"e_1_2_11_77_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2010.1.397"},{"key":"e_1_2_11_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.011"},{"key":"e_1_2_11_79_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.198465"},{"key":"e_1_2_11_80_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13041"},{"key":"e_1_2_11_81_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.11.038"},{"key":"e_1_2_11_82_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1213-5"},{"key":"e_1_2_11_83_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-07-295444"},{"key":"e_1_2_11_84_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V128.22.4940.4940"},{"key":"e_1_2_11_85_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00280117"},{"key":"e_1_2_11_86_1","volume-title":"Soliris (Eculizumab) [Prescribing Information]","year":"2020"},{"key":"e_1_2_11_87_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfw314"},{"key":"e_1_2_11_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.06.022"},{"key":"e_1_2_11_89_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30062-4"},{"key":"e_1_2_11_90_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000279"},{"key":"e_1_2_11_91_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6627e1"},{"key":"e_1_2_11_92_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208981"},{"key":"e_1_2_11_93_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11936-019-0797-1"},{"key":"e_1_2_11_94_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004005"},{"key":"e_1_2_11_95_1","doi-asserted-by":"publisher","DOI":"10.1080\/10641955.2016.1242606"},{"key":"e_1_2_11_96_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx355"},{"key":"e_1_2_11_97_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_2_11_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.12.012"},{"key":"e_1_2_11_99_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k5287"},{"key":"e_1_2_11_100_1","doi-asserted-by":"publisher","DOI":"10.1002\/prp2.644"},{"key":"e_1_2_11_101_1","unstructured":"Aldactone Package Insert Rev.2018."},{"key":"e_1_2_11_102_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000107"},{"key":"e_1_2_11_103_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.932766"},{"key":"e_1_2_11_104_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2019.100083"},{"key":"e_1_2_11_105_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.173356"},{"key":"e_1_2_11_106_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2018.04.007"},{"key":"e_1_2_11_107_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2007.09.007"},{"key":"e_1_2_11_108_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.430"},{"key":"e_1_2_11_109_1","unstructured":"Cleveland Clinic: Cervix. Accessed December 1 2022.Https:\/\/My.Clevelandclinic.Org\/Health\/Body\/23279\u2010Cervix"},{"key":"e_1_2_11_110_1","unstructured":"Cleveland Clinic: Placenta. Accessed December 1 2022.Https:\/\/My.Clevelandclinic.Org\/Health\/Body\/22337\u2010Placenta"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2837","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:26:08Z","timestamp":1761045968000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.2837"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,23]]},"references-count":109,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1002\/phar.2837"],"URL":"https:\/\/doi.org\/10.1002\/phar.2837","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,23]]},"assertion":[{"value":"2022-12-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}