Al-Suleiman SA, Qutub HO, Rahman J, Rahman MS. Obstetric admissions to the intensive care unit: a 12-year review.
Arch Gynecol Obstet 2006;
274:4-8. [PMID:
16432668 DOI:
10.1007/s00404-004-0721-z]
[Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Accepted: 12/01/2004] [Indexed: 11/28/2022]
Abstract
OBJECTIVE
The objective was to ascertain the prevalence, causes and outcome of critically ill obstetric patients admitted to the intensive care unit (ICU).
DESIGN
The design was a retrospective collection of data.
SETTINGS
The setting was a multidisciplinary ICU in a University hospital.
PATIENTS
All obstetric patients admitted to the ICU over a 12-year period from May 1992 to April 2004 were reviewed.
METHODS
Data collected included demographic characteristics of the patients, pre-existing medical conditions, obstetric complications, invasive procedures required in the ICU and outcome of the patients.
RESULTS
The incidence of obstetric admissions to the ICU represented 0.22% of all deliveries during the study period. The majority (84.4%) of patients were admitted to the ICU postpartum. Obstetric haemorrhage (32.8%) and pregnancy-induced hypertension (17.2%) were the two main obstetrical reasons for admission. The remainder included medical disorders (37.5%) and other causes (6.2%). Associated major complications included adult respiratory distress syndrome (ARDS) and HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome. The perinatal mortality rate was 20% and the maternal mortality rate 9.4%.
CONCLUSIONS
A team approach consisting treatment by obstetricians, intensive care specialists and anaesthesiologists provided optimal care for the patients. Improved management strategies for obstetric haemorrhage and hypertension may significantly reduce maternal morbidity.
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