Analytical Study of Patients Admitted in Obstetric Icu at Tertiary Care Centre.

Abstract

:This work is a cross sectional study at a tertiary care centre done over a duration of one year with the aim to determine major indications and incidence of obstetric ICU admissions, to find out duration of ICU stay and determine maternal outcome. The three most common indications of Obstetric ICU admission were haemmorrhage followed by hypertensive disorders and iron deficiency anemia.The mean duration of ICU stay was 6.1 days. Maternal mortality was 6.54 % of the total obstetric patients admitted to our ICU. To conclude , establishment of dedicated obstetric ICU at tertiary care centre with knowledge , familarity, experience and expertise of an obstetrician and special team would be the best place to monitor and treat a critically ill obstetric patient which will reduce the maternal morbidity and mortality. KEY WORDS: Obstetric ICU, morbidity, mortality,Obstetrics INTRODUCTION:Over the centuries anemia, eclampsia and haemorrhagic shock have killed millions of our pregnant women and still continue to do so. Inspite of great advances in the medical field and improved quality of healthcare available in our country, the maternal mortality in India is very high.(420 deaths /1,00,000 live birth).Due to lack of awareness and absence of regular antenatal care, the critically ill patients are referred late and sometimes in moribund conditions with multiple organ damage. In order to provide them specialised care and reduce maternal mortality specialised obstetric intensive care units have been established. The concept is yet to gain stronghold in our country.Management of the critically ill obstetric patients is very complex and requires cooperation of both obstetrician and intensivist/anesthetist .The primary objective of the present study was to review the characteristics and outcome of the obstetric patients admitted to our ICU over a one year period . Aims and objectives 1. To determine the incidence of Obstetric ICU admission. 2. To find out common indications of Obstetric ICU admission. 3. To study the interventions required. 4. To find out the duration of ICU stay. 5. To study the maternal outcome.

Study of obstetric patients admitted to Intensive Care Unit (ICU) at Kathmandu Medical College Teaching Hospital

“…The need for critical care support and admission to Intensive Care Unit (ICU) in obstetric patient is relatively infrequent as they are young and healthy group of patients [1][2][3][4][5][6][7] . Pregnancy, delivery and puerperium can be complicated by maternal morbidity necessitating obstetricians, nurses and neonatologists [1][2][3][4][5][6][7] .…”

“…Pregnancy, delivery and puerperium can be complicated by maternal morbidity necessitating obstetricians, nurses and neonatologists [1][2][3][4][5][6][7] . Although obstetric patients form a significant proportion of ICU admission in developing countries, there are only few studies reporting on critical illness during preganancy 2,4-6 .…”

Evaluation of Clinical Characteristics and Outcomes of Obstetric Patients Admitted to Intensive Care Unit

“…[8] HDP was the leading indication in similar studies from the region. [2,10,11] This finding highlights the fact that hypertensive disorder still tops the list of obstetric morbidities in our part of the world. The lack of proper antenatal supervision results in increased incidence of HDP.…”

“…[7] This finding is comparable to that of other studies as well. [1,2,8] Obstetric admission to ICU is a management based approach largely governed by the judgment of treating consultants and availability of high dependency units (HDU) facilities. Moreover, there are no published guidelines for obstetric admission to ICU.…”

“…Yet pregnancies, though physiological and largely uneventful, can become complicated by various morbidities necessitating ICU admission. [1,2] Critically ill obstetric patients present a unique challenge in terms of management, often requiring active involvement of multiple specialties. This cohort of patients is different in that their management requires consideration of the physiological changes associated with pregnancy as well as concern for the well-being of the fetus.…”