Characteristics of obstetric intensive care unit admissions in New Jersey

Madan, Ichchha; Puri, Isha; Jain, Nutan; Grotegut, Chad A.; Nelson, Deb; Dandolu, Vani

doi:10.1080/14767050902874097

Cited by 5 publications

(11 citation statements)

References 12 publications

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“…Poor glycemic control during pregnancy can lead to diabetic ketoacidosis, as a result of an increased incidence of ICU referrals. [15,16] Thrombocytopenia, surgical, or heart diseases may worsen the condition of patients during pregnancy, [15,17] which may be the cause of referral.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of obstetric admissions to the intensive care unit

Lin

Chen²,

Sun³

et al. 2019

Medicine

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The aim of this study was to identify risk factors among obstetric patients admitted to the intensive care unit (ICU).The study was conducted in Third Affiliated Hospital of Guangzhou Medical University during January 1, 2009 and December 31, 2016. A total of 44,817 pregnant women ≥20 weeks of gestational age were scanned. Demographic characteristics, perinatal outcomes, and risk factors among participants were analyzed.A number of factors (21) were more prevalent in the ICU admission group. The greatest for admission to the ICU occurred with amniotic fluid embolism, heart disease, acute fatty liver, and referral for care. The incidence of postpartum hemorrhage, hysterectomy, organ failure, and method of delivery differed significantly between groups (P < .05). Adverse neonatal outcome differed significantly between groups (P < .05).Complications of pregnancy are risk factors for referral to the ICU and may increase risk for unexpected outcomes among mothers and neonates.

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Section: Discussionmentioning

confidence: 99%

Risk factors of obstetric admissions to the intensive care unit

Lin

Chen²,

Sun³

et al. 2019

Medicine

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“…Our present study has found quite a similar pattern with other such studies indicating the criteria for admission to ICU. [679–11] In our study, the education level of not just the patients but also the relatives determines the time, type and level of health care sought by them. To add insult to the injury, there were other contributing factors to their deterioration like poor financial status, transportation facilities, poor rural health infrastructure and customs and traditions of local community.…”

Section: Discussionmentioning

confidence: 99%

“…The intervention strategies designed for the treatment of our patients were quite comparable with the methodologies employed by other authors. [7]…”

Section: Discussionmentioning

confidence: 99%

“…The hemorrhagic disorders most commonly occurred as a result of uterine atony due to prolonged or obstructed labor, retained products as well as due to iatrogenic causes, reflecting our poor obstetrical rural infrastructure and facilities and all these results are quite consistent with those of other such studies. [781516] Provision of safe blood supply is an integral part of our national programs directed at improving safe motherhood practices. Though there was no shortage of blood and blood products in our blood bank, the patients who died of hemorrhage were the ones who came very late to our institution.…”

Section: Discussionmentioning

confidence: 99%

“…These factors, combined with some structural and functional health problems, do not allow the developing countries to achieve targets in obstetrical critical care as those in developed countries. [5–7]…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is intensive care the only answer for high risk pregnancies in developing nations?

Bajwa

Kaur

et al. 2010

J Emerg Trauma Shock

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Background:Management of high risk obstetric patients.Aim:The present study was conducted to evaluate the primary causes of the admission of obstetric patients to Intensive Care Unit (ICU), the presence of co-morbid diseases, outcome of such patients, their survival rate as well as the factors which contribute to the maternal mortality.Settings and Design:A retrospective study was conducted in the Department of Obstetrics and Gynaecology and Anaesthesiology/ICU of our Institute.Materials and Methods:Sixty-one obstetric patients, who were admitted to ICU between 20 December 2006 and 31 January 2010, were evaluated for various factors responsible for their admission as well as their outcome.Statistical Analysis:At the end of study, the data were arranged systematically and subjected to statistical analysis using nonparametric tests and P value <0.05 was considered significant.Results:Majority of the 61 patients admitted in ICU were referred from the peripheral health centers, smaller nursing homes/hospitals and some even without proper primary care and mainly comprising uneducated and rural population. Hemorrhage, pregnancy induced hypertension, cardiac diseases, respiratory insufficiency and sepsis were the main causes for admission. A total of 18 patients among 61 died during their ICU stay in the hospital.Conclusions:In the developing countries, high risk pregnancy should be managed at peripheral centers with proper facilities, antenatal visits and timely referral. The intensive care help should be reserved for very high risk pregnancies with co-morbid diseases.

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The Management of the Critically Ill Obstetric Patient

Honiden

Abdel-Razeq

Siegel

2011

J Intensive Care Med

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Hypertensive disorders, postpartum hemorrhage, and sepsis are the most common indications for intensive care unit admission among obstetric patients. In general, ICU mortality is low, and better than would be predicted using available mortality prediction tools. Provision of care to this special population requires an intimate understanding of physiologic changes that occur during pregnancy. Clinicians must be aware of the way various diagnostic and treatment choices can affect the mother and fetus. Most clinically necessary radiographic tests can be safely performed and fall under the maternal radiation exposure limit of less than 0.05 Gray (Gy). Careful attention must be paid to acid-base status, oxygenation, and ventilation when faced with respiratory failure necessitating intubation. Cesarean delivery can be justified after 4 minutes of cardiac arrest and may improve fetal and maternal outcomes. The treatment of obstetric patients in the ICU introduces complexities and challenges that may be unfamiliar to many critical care physicians; teamwork and communication with obstetricians is crucial.

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Characteristics of obstetric intensive care unit admissions in New Jersey

Abstract: Pregnancy complications are predictive of ICU admission amongst pregnant patients after adjusting for demographic factors.

Cited by 5 publications

References 12 publications

Risk factors of obstetric admissions to the intensive care unit

Risk factors of obstetric admissions to the intensive care unit

Is intensive care the only answer for high risk pregnancies in developing nations?

The Management of the Critically Ill Obstetric Patient

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