Evaluation of obstetric admissions to intensive care unit of a tertiary referral center in coastal India
B Poornima R Bhat, Mahesha H. Navada, Sujaya V. Rao, G. Nagarathna
Hemorrhage, intensive care unit, maternal death, maternal morbidity
Citation Information :
Bhat BP, Navada MH, Rao SV, Nagarathna G. Evaluation of obstetric admissions to intensive care unit of a tertiary referral center in coastal India. Indian J Crit Care Med 2013; 17 (1):34-37.
Background and Aim: To evaluate the occurrence, indications, course, interventions, and outcome of obstetric patients admitted to the intensive care unit (ICU). Design: Retrospective study. Setting: ICU of a Medical College Hospital. Materials and Methods: The data collected were age, parity, obstetric status, primary diagnosis, interventions, and outcome of obstetric patients admitted to the ICU from Jan 2005 to June 2011. Results: Total deliveries were 16,804 in 6.5 years. Obstetric admissions to the ICU were (n = 65) which constitutes 0.39% of deliveries. Majority of the admissions were in the postpartum period (n = 46, 70.8%). The two common indications for admission were obstetric hemorrhage (n = 18, 27.7%) and pregnancy related hypertension with its complications (n = 17, 26.2%). The most common intervention was artificial ventilation (n = 41, 63%). The mortality among obstetric admissions in the ICU was (33.8% (22/65)). The patients appropriate for High Dependency Unit (HDU) care was (32.3% (21/65)). The statistical analysis was done by fractional percentage and Chi-square test. Conclusions: Hemorrhage and pregnancy-related hypertension with its complications are the two common indications for ICU admissions. The need for a HDU should be considered.
Kilpatrick SJ, Matthay M. Obstetric patients requiring critical care. A five-year review. Chest 1992;101:1407-12.
Mabie WC, Sibai BM. Treatment in an obstetric intensive care unit. Am J Obstet Gynecol 1990;162:1-4.
Umo-Etuk J, Lumley J, Holdcroft A. Critically ill parturient women and admission to intensive care: A 5-year review. Int J Obstet Anesth 1996;5:79-84.
Wheatley E, Farkas A, Watson D. Obstetric admissions to an intensive therapy unit. Int J Obstet Anesth 1996;5:221-4.
Collop NA, Sahn SA. Critical illness in pregnancy. An analysis of 20 patients admitted to a medical intensive care unit. Chest 1993;103:1548-52.
Gilbert TT, Smulian JC, Martin AA, Ananth CV, Scorza W, Scardella AT, et al. Obstetric admissions to the intensive care unit: Outcomes and severity of illness. Obstet Gynecol 2003;102:897-903.
Mahutte NG, Murphy-Kaulbeck L, Le Q, Solomon J, Benjamin A, Boyd ME. Obstetric admissions to the intensive care unit. Obstet Gynecol 1999;94:263-6.
Platteau P, Engelhardt T, Moodley J, Muckart DJ. Obstetric and gynaecological patients in an intensive care unit: A 1 year review. Trop Doct 1997;27:202-6.
Making pregnancy safer. WHO Regional Office for Europe. Available from: http://www.euro.who.int/pregnancy. [Last accessed on 2008 Sep].
Leung NY, Lau AC, Chan KK, Yan WW. Clinical characteristics and outcomes of obstetric patients admitted to the intensive care unit: A 10-years retrospective review. Hong Kong Med J 2010;16:18-25.
Soubra SH, Guntupalli KK. Critical illness in pregnancy: An overview. Crit Care Med 2005;33 (10 Suppl):248-55.
Kuppuswamy (2011) Socio-Economic-Status-Scale. Available from: http://www.scribd.com/doc/28303914/. [Last accessed on 2011 Nov].
Ash A. High dependency care in obstetrics: Progress in obstetrics and gynecology. Vol. 17. New Delhi: Churchchill Living stone, Elsevier; 2007. p. 183-200.
Keizer JL, Zwart JJ, Meerman RH, Harinck BI, Feuth HD, van Roosmalen J. Obstetric intensive care admissions: A 12-year review in a tertiary care centre. Eur J Obstet Gynecol Reprod Biol 2006;128:152-6.
Vasquez DN, Estenssoro E, Canales HS, Reina R, Saenz MG, Das Neves AV, et al. Clinical characteristics and outcomes of obstetric patients requiring ICU admission. Chest 2007;131:718-24.
Karnad DR, Lapsia V, Krishnan A, Salvi VS. Prognostic factors in obstetric patients admitted to an Indian intensive care unit. Crit Care Med 2004;32:1294-9.
Gupta S, Naithani U, Doshi V, Bhargava V, Vijay BS, Obstetric critical care: A prospective analysis of clinical characteristics, predictability, and fetomaternal outcome in a new dedicated obstetric intensive care unit. Indian J Anaesth 2011;55:146-53.
el-Solh AA, Grant BJ. A comparison of severity of illness scoring systems for critically ill obstetric patients. Chest 1996;110:1299-304.
Mirghani HM, Hamed M, Ezimokhai M, Weerasinghe DS. Pregnancy-related admissions to the intensive care unit. Int J Obstet Anesth 2004;13:82-5.