Health crises hinder the provision of intensive care for critical obstetric conditions such as preeclampsia and eclampsia, where timely decision making and system capacity directly impact maternal and fetal outcomes. This study compared the clinical and epidemiological profile and care processes in the ICU for cases of preeclampsia and eclampsia before and during the COVID-19 health crisis in Alto Amazonas, Loreto (Peru), using a comparative mixed-method approach. Quantitative data were obtained from ICU medical records for two periods (2015–2019 and 2020–2022). Categorical variables were compared using exact methods (Fisher’s exact test for 2 × 2 tables and exact procedures for scatter tables with multiple categories), and continuous variables were compared using nonparametric tests where appropriate. The most notable change was an increase in the frequency of cesarean sections during the health crisis, which should be interpreted with caution given the small sample size and potential changes in admission criteria and system limitations. Other clinical indicators and discharge status showed no clear evidence of substantial differences between the periods. Qualitative findings highlighted systemic limitations affecting continuity of care, particularly those related to timely access to safe blood products and referral pathways. These results align with SDG 3 (Good Health and Well-being) and support strengthening preparedness, referral coordination, and the availability of essential resources to protect maternal health during large-scale emergencies.

Health crises represent a challenge in the care of critical conditions such as pre-eclampsia, which puts maternal-fetal life at risk. During the pandemic, ICU response capacity was compromised, requiring adjustments in clinical protocols to ensure safe and effective care. This study aimed to compare the clinical and epidemiological profile of preeclamp-sia-eclampsia in ICU patients before and during the health crisis in Alto Amazonas, Lore-to, between 2015 and 2022, identifying significant changes and areas of improvement for future public health emergencies. A mixed approach with a comparative and cross-sectional design was employed. The sample included patients diagnosed with pre-eclampsia, selected under inclusion criteria and analyzed using the Mann-Whitney U test and Wilcoxon's W test. The results revealed an increase in the frequency of cesarean sections during the pandemic (93.3% vs. 24.2% before the crisis; p< 0.001), reflecting changes in obstetric protocols. Likewise, obstetric history showed significant differences (p=0.033), while disease severity and condition at discharge did not show substantial vari-ations (p>0.05). In the qualitative analysis, the specialists pointed out limitations in access to safe blood and referral protocols. These findings are linked to SDG 3: Health and Well-being, highlighting the need to strengthen the system's response capacity.