OBJECTIVE: To review the clinical characteristics and outcomes of critically ill obstetrical patients and to determine the outcome predictability using the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system. METHODS: A retrospective data collection of all obstetrical patients (n = 49) admitted for more than 24 hours to the Intensive Care Unit at Kwong Wah Hospital from 1988 to 1995 was conducted. Demographics, obstetric data, preexistent medical problems, diagnosis, days staying in the ICU and ICU related data were recorded for each patient. RESULTS: Obstetric admissions to ICU during the study period represented 0.12% of all deliveries during this period. There was a predominance of postpartum admissions and obstetric diagnosis responsible for the patients' critical illness. Massive postpartum haemorrhage was the single most common cause of ICU admission, representing 53.0% of all patients. Preeclampsia and eclampsia (14.3%), anaesthesia related complications (14.3%), and medical diseases complicating pregnancy (14.3%) were the other common disease categories for ICU admission. Two cases (4.1%) of surgical disease complicating pregnancy were admitted. The maternal mortality rate was 5.1 deaths per 100,000 total births, or 2 maternal deaths in 39,354 total deliveries in this study period. All deaths were due to nonobstetric causes. The perinatal mortality rate was 10.0% (5 cases) in this study group. CONCLUSIONS: When applying the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system in predicting the final outcome in this group of obstetric patients, we found that our obstetric patients requiring intensive care had a better outcome than predicted, as expressed by a low mortality ratio (0.25).
OBJECTIVE: To review the clinical characteristics and outcomes of critically ill obstetricalpatients and to determine the outcome predictability using the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system. METHODS: A retrospective data collection of all obstetricalpatients (n = 49) admitted for more than 24 hours to the Intensive Care Unit at Kwong Wah Hospital from 1988 to 1995 was conducted. Demographics, obstetric data, preexistent medical problems, diagnosis, days staying in the ICU and ICU related data were recorded for each patient. RESULTS: Obstetric admissions to ICU during the study period represented 0.12% of all deliveries during this period. There was a predominance of postpartum admissions and obstetric diagnosis responsible for the patients' critical illness. Massive postpartum haemorrhage was the single most common cause of ICU admission, representing 53.0% of all patients. Preeclampsia and eclampsia (14.3%), anaesthesia related complications (14.3%), and medical diseases complicating pregnancy (14.3%) were the other common disease categories for ICU admission. Two cases (4.1%) of surgical disease complicating pregnancy were admitted. The maternal mortality rate was 5.1 deaths per 100,000 total births, or 2 maternal deaths in 39,354 total deliveries in this study period. All deaths were due to nonobstetric causes. The perinatal mortality rate was 10.0% (5 cases) in this study group. CONCLUSIONS: When applying the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system in predicting the final outcome in this group of obstetric patients, we found that our obstetric patients requiring intensive care had a better outcome than predicted, as expressed by a low mortality ratio (0.25).
Authors: John Allotey; Kym Ie Snell; Melanie Smuk; Richard Hooper; Claire L Chan; Asif Ahmed; Lucy C Chappell; Peter von Dadelszen; Julie Dodds; Marcus Green; Louise Kenny; Asma Khalil; Khalid S Khan; Ben W Mol; Jenny Myers; Lucilla Poston; Basky Thilaganathan; Anne C Staff; Gordon Cs Smith; Wessel Ganzevoort; Hannele Laivuori; Anthony O Odibo; Javier A Ramírez; John Kingdom; George Daskalakis; Diane Farrar; Ahmet A Baschat; Paul T Seed; Federico Prefumo; Fabricio da Silva Costa; Henk Groen; Francois Audibert; Jacques Masse; Ragnhild B Skråstad; Kjell Å Salvesen; Camilla Haavaldsen; Chie Nagata; Alice R Rumbold; Seppo Heinonen; Lisa M Askie; Luc Jm Smits; Christina A Vinter; Per M Magnus; Kajantie Eero; Pia M Villa; Anne K Jenum; Louise B Andersen; Jane E Norman; Akihide Ohkuchi; Anne Eskild; Sohinee Bhattacharya; Fionnuala M McAuliffe; Alberto Galindo; Ignacio Herraiz; Lionel Carbillon; Kerstin Klipstein-Grobusch; SeonAe Yeo; Helena J Teede; Joyce L Browne; Karel Gm Moons; Richard D Riley; Shakila Thangaratinam Journal: Health Technol Assess Date: 2020-12 Impact factor: 4.014
Authors: Matthew P Johnson; Shaun P Brennecke; Christine E East; Harald H H Göring; Jack W Kent; Thomas D Dyer; Joanne M Said; Linda T Roten; Ann-Charlotte Iversen; Lawrence J Abraham; Seppo Heinonen; Eero Kajantie; Juha Kere; Katja Kivinen; Anneli Pouta; Hannele Laivuori; Rigmor Austgulen; John Blangero; Eric K Moses Journal: PLoS One Date: 2012-03-14 Impact factor: 3.240
Authors: Joost J Zwart; Just R O Dupuis; Annemiek Richters; Ferko Ory; Jos van Roosmalen Journal: Intensive Care Med Date: 2009-11-10 Impact factor: 17.440