OBJECTIVE: The objective was to ascertain the prevalence, causes and outcome of critically ill obstetric patients admitted to the intensive care unit (ICU). DESIGN: The design was a retrospective collection of data. SETTINGS: The setting was a multidisciplinary ICU in a University hospital. PATIENTS: All obstetric patients admitted to the ICU over a 12-year period from May 1992 to April 2004 were reviewed. METHODS: Data collected included demographic characteristics of the patients, pre-existing medical conditions, obstetric complications, invasive procedures required in the ICU and outcome of the patients. RESULTS: The incidence of obstetric admissions to the ICU represented 0.22% of all deliveries during the study period. The majority (84.4%) of patients were admitted to the ICU postpartum. Obstetric haemorrhage (32.8%) and pregnancy-induced hypertension (17.2%) were the two main obstetrical reasons for admission. The remainder included medical disorders (37.5%) and other causes (6.2%). Associated major complications included adult respiratory distress syndrome (ARDS) and HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome. The perinatal mortality rate was 20% and the maternal mortality rate 9.4%. CONCLUSIONS: A team approach consisting treatment by obstetricians, intensive care specialists and anaesthesiologists provided optimal care for the patients. Improved management strategies for obstetric haemorrhage and hypertension may significantly reduce maternal morbidity.
OBJECTIVE: The objective was to ascertain the prevalence, causes and outcome of critically ill obstetricpatients admitted to the intensive care unit (ICU). DESIGN: The design was a retrospective collection of data. SETTINGS: The setting was a multidisciplinary ICU in a University hospital. PATIENTS: All obstetric patients admitted to the ICU over a 12-year period from May 1992 to April 2004 were reviewed. METHODS: Data collected included demographic characteristics of the patients, pre-existing medical conditions, obstetric complications, invasive procedures required in the ICU and outcome of the patients. RESULTS: The incidence of obstetric admissions to the ICU represented 0.22% of all deliveries during the study period. The majority (84.4%) of patients were admitted to the ICU postpartum. Obstetric haemorrhage (32.8%) and pregnancy-induced hypertension (17.2%) were the two main obstetrical reasons for admission. The remainder included medical disorders (37.5%) and other causes (6.2%). Associated major complications included adult respiratory distress syndrome (ARDS) and HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome. The perinatal mortality rate was 20% and the maternal mortality rate 9.4%. CONCLUSIONS: A team approach consisting treatment by obstetricians, intensive care specialists and anaesthesiologists provided optimal care for the patients. Improved management strategies for obstetric haemorrhage and hypertension may significantly reduce maternal morbidity.
Authors: Alexander M Friedman; Cande V Ananth; Yongmei Huang; Mary E D'Alton; Jason D Wright Journal: Am J Obstet Gynecol Date: 2016-07-22 Impact factor: 8.661