Why Obstetric Patients are admitted to Intensive Care Unit? A Retrospective Study

Ghike, Sunita; Asegaonkar, Prashant

doi:10.5005/jp-journals-10006-1181

Cited by 10 publications

(11 citation statements)

References 5 publications

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“…Mean age of patients in our study was 25.4 years which is comparable to another Indian study (Ghike S et al 2012). 62 %( 31 out of 50 patients) requiring obstetric critical care were referrals from peripheral units to our tertiary care centre which is similar to 61.8% of another study (Bhadade et al2012).…”

Section: Discussionsupporting

confidence: 86%

Obstetric admissions to the critical care unit: a one year experience at a tertiary care referral centre of the developing country

Agarwal

Mukhopadhyay

Dahiya

et al. 2017

IJM

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Background: Care of the critically ill pregnant women presents a unique challenge as the assessment, monitoring and the treatment must take into account both maternal and fetal wellbeing as well as physiological changes of pregnancy. Objective: To assess the indications for critical care unit transfer of obstetric and postpartum cases and describe the profile and fetomaternal outcomes of such patients. Methods: This prospective observational study was conducted in department of Obstetrics and Gynaecology of Medical College and Hospital, Kolkata from 1 st May 2013 to 30 th April 2014.Total 50 cases were included and data was analysed by frequency, percentage, paired and unpaired t test, chi square test and test of equality of proportions using SPSS version 20. Results: 0.9% of total obstetric and postpartum admissions required critical care facilities and contributed to 16.67% of CCU admissions. Mean age of patients included in our study was 25.4 years. Most of the patients were admitted antepartum (n=37, 74%) with mean gestational age at admission being 34.2703+6.85018 weeks. More patients presented with obstetric complications (74%, n=37) as compared to medical complications (26%, n=13). The most common indication for admission were major haemorrhage (n=18, 36%) and hypertensive disorders of pregnancy (n=17, 34%). There were 16(32%) maternal deaths. MODS (31.25%) and hypovolemic shock (18.75%) were the most common causes of maternal death in our study. Conclusion:The overall mortality was high, emphasizing the need for dedicated obstetric high dependency units.

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Section: Discussionsupporting

confidence: 86%

Obstetric admissions to the critical care unit: a one year experience at a tertiary care referral centre of the developing country

Agarwal

Mukhopadhyay

Dahiya

et al. 2017

IJM

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“…This is comparable to the rate of 0.4%-2.4% reported by other authors (2-6). The mean age of patients and gestational age at the time of hospitalization were similar to previous studies (2,4,7). Pregnancy-induced hypertension is a common cause of maternal morbidity and mortality, especially in developing countries (2,7-10).…”

Section: Discussionsupporting

confidence: 86%

Outcome of Patients Admitted to Obstetric Intensive Care Unit With Severe Preeclampsia, Eclampsia or HELLP Syndrome

Atashkhoei¹,

Lame²

2015

IJWHR

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Introduction Preeclampsia is a relatively common hypertensive disorder during pregnancy. Preeclampsia occurs in about 5%-15% of all pregnant women, may cause dangerous complication and even death in the mother and fetus (1). In 5% of all cases, preeclampsia can progress toward eclampsia, and up to 19% of the cases present with HELLP syndrome, maternal and perinatal mortality can be increased (2). Severe preeclampsia and its associated complications are considered as the leading main indications for intensive care unit (ICU) admission (3-7). The most common indications for admission to the ICU of patients with pregnancy-induced hypertension include but are not limited to refractory hypertension, neurological dysfunction (intracranial hemorrhage, seizures, and elevated intracranial pressure), liver or kidney dysfunction, pulmonary edema, HELLP syndrome, and/or disseminated intravascular coagulation (DIC) (2,8-10). There are several studies of critically ill obstetric patients, but little has been studied on the maternal and perinatal outcomes of patients with preeclampsia, eclampsia or HELLP syndrome (2,11). The aim of the present retrospective study was to evaluate the frequency, indications, interventions and clinical outcomes of patients with severe preeclampsia, eclampsia, and HELLP syndrome admitted to the ICU. Materials and Methods After obtaining the written approval of the ethical committee of hospital, this study was conducted. Records of all preeclamptic and eclamptic patients and pregnancy conditions indicating HELLP syndrome which needed intensive care in Al-Zahra hospital, Tabriz University of Medical Sciences were reviewed retrospectively within 1-year from March 2012 to March 2013. Studied data included clinical epidemiological variables, laboratory test parameters, diagnostic and therapeutic interventions, rate of morbidity and mortality and its related factors, and the average duration of ICU stay. Descriptive statistics were used for categorical data as frequency (n) or percentage (%) and for continuous parameters as mean ± SD, or as median range on the presence or absence of a normal data distribution. Categorical variables were analyzed by chi-square test or Fisher exact test, as appropriate. SPSS 16 was used for data analysis. Results In this study, 35 (62.5%) women with severe preeclampsia, 2 (3.5%) women with eclampsia and 19 (34%) patients with HELLP syndrome were studied. Total number of

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“…The observed rate is rather very low in comparison to most of the studies. 5,12,13 Major cause of mortality in our patients was haemorrhage and majority presented in decompensated state, thus reflecting the lack of well-equipped maternal care. Authors observed a higher caesarean delivery rate (50.7%) in the ICU cohort.…”

Section: Discussionmentioning

confidence: 88%

Obstetrics ICU admissions: challenges faced at a tertiary referral centre

Jamal

Mehta

Goel

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Management of critically ill patients in obstetrics is a challenge owing to the changed physiology and unpredictability of the disease behaviour. Stratification strategy for early admission to obstetric ICU is imperative to reduce maternal morbidity and mortality. Due to lack of formal surveys regarding obstetrical ICU in our country, there is lack of precise national data on obstetrical ICU mortality. Aim of the present study was to estimate the obstetric ICU admission rate, to study the pattern of causative aetiology and to study the complications developed in ICU.Methods: The present study is a retrospective analytical study done in the Department of Obstetrics and Gynecology, from January 2015 to August 2017.Results: During the study period there were a total of 8466 obstetrical admissions, 2508 deliveries and 104 ICU admissions. Out of 104, analysis was done on 71 patients. Hypertensive disorders of the pregnancy were associated with maximum number of admissions (47.8%), followed by postpartum haemorrhage (12.6%). Maximum admissions were in postpartum period (63.4%). Anaemia was associated with 35.2% of the cases and it was closely followed by sepsis (28.2%). Mechanical ventilation was required for 30.9% of the patients.Conclusions: Hypertensive disorders of the pregnancy, haemorrhage and sepsis are the major risk factors for ICU admission in obstetric population.

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Why Obstetric Patients are admitted to Intensive Care Unit? A Retrospective Study

Cited by 10 publications

References 5 publications

Obstetric admissions to the critical care unit: a one year experience at a tertiary care referral centre of the developing country

Obstetric admissions to the critical care unit: a one year experience at a tertiary care referral centre of the developing country

Outcome of Patients Admitted to Obstetric Intensive Care Unit With Severe Preeclampsia, Eclampsia or HELLP Syndrome

Obstetrics ICU admissions: challenges faced at a tertiary referral centre

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