The Management of the Critically Ill Obstetric Patient

Honiden, Shyoko; Abdel-Razeq, Sonya S.; Siegel, Mark D.

doi:10.1177/0885066611411408

Cited by 17 publications

(6 citation statements)

References 114 publications

(124 reference statements)

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“…Likewise, in referral hospitals, the improvement of indicators that are related to special techniques such as assessment of biophysical profile, evaluation of fetal growth restriction, or arterial embolization was uncertain. A recent review supported that hypertensive disorders and PPH are common among critically ill obstetric patients admitted in the intensive care unit of which holistic close monitoring and management are needed (Honiden, Abdel‐Razeq, & Siegel, ).…”

Section: Discussionmentioning

confidence: 99%

Development and Assessment of Indicators for Quality of Care in Severe Preeclampsia/Eclampsia and Postpartum Hemorrhage

Talungchit

Liabsuetrakul

Lindmark

2013

Journal for Healthcare Quality

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Severe preeclampsia/eclampsia and postpartum hemorrhage (PPH) are serious obstetric problems worldwide. Quality improvement of care measured by evidence-based indicators is recommended as a recent important strategy; however, the indicators for quality of care of these two conditions have not been established. This study aimed to develop such indicators and assess their validity, reliability, and feasibility at different contextual levels. Of 32 initially valid indicators for care of severe preeclampsia/eclampsia, after two rounds of Delphi technique, 21 and 30 indicators were agreed to be suitable to monitor care at district and referral hospitals. Of 13 initial indicators for PPH, 8 and 13 indicators were selected, respectively. The interrater reliability of indicators varied from 0.28 to 0.63. At least three-fourths of all indicators rated by local doctors and nurses were assessed as feasible in terms of relevance, measurability, and improvability. The process identified reliable and feasible performance indicators to monitor quality of care in severe preeclampsia/eclampsia and PPH for either basic or comprehensive emergency obstetric care (EmOC). The informative applicability of these indicators in clinical practice needs further evaluation.

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Section: Discussionmentioning

confidence: 99%

Development and Assessment of Indicators for Quality of Care in Severe Preeclampsia/Eclampsia and Postpartum Hemorrhage

Talungchit

Liabsuetrakul

Lindmark

2013

Journal for Healthcare Quality

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“…Complications in pregnancy resulting from chronic and acute medical disorders are developing as a significant cause of morbidity and mortality. 2 …”

Section: Introductionmentioning

confidence: 99%

Obstetric patients in intensive care unit: Perspective from a teaching hospital in Pakistan

et al. 2016

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ObjectiveReview of obstetric cases admitted to the intensive care unit.DesignTen year retrospective review of individual patients' medical records.ParticipantsRecords of obstetric patients admitted from 2005–2014.SettingAga Khan University Hospital KarachiMain Outcome measuresDiagnosis at the time of admission, associated risk factors, and intervention required aspects of management and rate of mortality.FindingsA total of 194 obstetric patients were admitted out of which 86.2% of patients had ventilator support. Mortality was not seen to be significantly associated with parity and antenatal/postnatal status. The median age of patients was 34 years, minimum length of stay was 24 hours and maximum stay was 53 days. Sixty one percent of patients were admitted to with organ system failure. The overall mortality rate was 21.64% (42/194). The mortality rate was five times more likely in patients who had gastro-intestinal complication {Odds Ratio=4.87; 95%CI: 1.65-14.36}. The largest group of patients {28.4%} presented with hematological diagnosis.ConclusionWhen the intensive care unit admission became essential, primary diagnosis included: postpartum hemorrhage, hypertensive disorders, sepsis and infectious diseases. An increased vigilance of high-risk pregnant women and a stabilization of their condition before intervention is administered, improves the outcome of these women.

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“…chronic hypertension, valvular heart disease and diabetes mellitus. 3 2. Patients with acute illnesses specific to the pregnancy, e.g.…”

Section: Categorization Of Critically Ill Obstetric Patientsmentioning

confidence: 99%

Obstetric risk factors requiring intensive care admission

Ismail

Aman

2020

APIC

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Management of high risk obstetric patients in critical care setting is challenged by altered physiology of pregnancy and concerns for the viability of the fetus. Pregnant patients, although young and healthy are at risk of developing thromboembolic complications, hemorrhage and infections. Obstetric hemorrhage, pre-eclampsia, cardiac diseases and sepsis are the main reasons for ICU admission in obstetric population. Delay in the diagnosis and correction of correctable conditions can ultimately require intensive care admission. There is a contrast in the overall incidence and prevalence of intensive care unit admission between developed and developing countries. Early clinical suspicion, timely referral and early institution of critical care of high risk patients may improve maternal outcome. Improvement of healthcare infrastructure and timely referral to tertiary care facilities may help reduce maternal mortality in developing countries. Received: 5 Sep 2018Reviewed: 7 Nov 2018Accepted: 10 Nov 2018 Citation: Ismail S, Aman A. Obstetric risk factors requiring intensive care admission. Anaesth Pain & Intensive Care 2018;22 Suppl 1:S129-S132

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The Management of the Critically Ill Obstetric Patient

Cited by 17 publications

References 114 publications

Development and Assessment of Indicators for Quality of Care in Severe Preeclampsia/Eclampsia and Postpartum Hemorrhage

Development and Assessment of Indicators for Quality of Care in Severe Preeclampsia/Eclampsia and Postpartum Hemorrhage

Obstetric patients in intensive care unit: Perspective from a teaching hospital in Pakistan

Obstetric risk factors requiring intensive care admission

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