Maternal Enhanced and Critical Care and Outcomes Over Three Years: A Descriptive Observational Study

Objective To describe the characteristics, care needs and outcomes of the enhanced maternal care (EMC) population.

Design A descriptive observational study.

Setting 13 acute NHS trusts in the Yorkshire and Humber region from January 2021 to October 2024.

Population 4321 patient care episodes captured in the Maternal Enhanced and Critical Care (MEaCC) database.

Methods A retrospective analysis of data from the MEaCC database for all care episodes between January 2021 and October 2024.

Outcome Measures Outcomes included patient demographics, mode of delivery, leading causes for EMC, physiological support needs, overall outcomes including mortality and requirement for ICU among the EMC population and proportion of EMC care delivered by EMC trained midwives.

Results 4321 episodes of EMC were recorded during this period. 9% of women required EMC or critical care, with most managed in maternity units: only 4% of EMC patients required critical care admission. 7% had invasive monitoring. The mean BMI was higher among MEaCC patients than regionally. Women of black ethnicity are more likely to require EMC or ICU. Most needing EMC would have been considered ‘low risk’ pregnancies.

Conclusions A significant proportion of women require higher levels of support during and after pregnancy. Training of midwives in EMC should be a priority. UK-wide capture of EMC data would allow benchmarking of care, highlight best practice, inform service commissioning and drive further research.