An observational study to evaluate the incidence, clinical profile of antenatal and postpartum women requiring admission to the ICU and the interventions required.
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 10, Pages 3690-3696
AbstractBackground: The outcome of obstetric patients admitted to the intensive care unit (ICU) depends on the number of factors.
Aim: to evaluate the incidence, clinical profile of antenatal and postpartum women requiring admission to the ICU the interventions required.
Material and methods: This prospective observational study was done the Department of Anaesthesiology, Government Medical College, Bettiah (West Champaran) Bihar, India, for 15 months. Data were recorded and analyzed for each patient: age, parity, primary diagnosis (obstetric or non-obstetric e.g. community-acquired pneumonia, rheumatic heart disease) responsible for the patient's critical illness, indication of ICU admission, obstetric interventions performed, critical care interventions performed during ICU stay (mechanical ventilation, central venous catheterization, invasive arterial pressure monitoring, hemodialysis), duration of mechanical ventilation, length of ICU stay and outcome of patient.
Results: During the study total 200 obstetric patients were admitted to the ICUs (4.44% of total ICU admissions). There were 12000 deliveries in this period, and the ICU admission rate was 16.67 per 1000 deliveries. The mean maternal age (in years) was 24.26±4.78 (mean±standard deviation). Primigravida (55%) were more as compared to multigravida (45%). Only 16% patients were in antepartum period while majority of patients (84%) were admitted during postpartum period. The main obstetric indications for ICU admission were pregnancy-induced hypertension (15%) followed by obstetric haemorrhage (9%) and community acquired pneumonia (7%), Other indications were valvular heart disease (5%) and monitoring (6.5%). In the present study maternal mortality among the women admitted to ICU was 16%. The leading cause of maternal death was obstetric haemorrhage (28.13%) followed by pregnancy induced hypertension (21.87%). An ICU intervention during the stay of the patients in terms of mechanical ventilation was used in 135 (67.5%) cases. Conclusion: A high quality multidisciplinary care is required in complicated pregnancies for safe motherhood. So, there is a need for dedicated ICU for obstetric patients.
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