Obstetric admissions to the intensive care unit: a 12-year review
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The objective was to ascertain the prevalence, causes and outcome of critically ill obstetric patients admitted to the intensive care unit (ICU).
The design was a retrospective collection of data.
The setting was a multidisciplinary ICU in a University hospital.
All obstetric patients admitted to the ICU over a 12-year period from May 1992 to April 2004 were reviewed.
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%.
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.
KeywordsIntensive care Pregnancy complications Critically ill patients Medical complications Maternal death
- 10.Report on Confidential Enquiries into Maternal Deaths in the United Kingdom 1988–1990 (1994) HMSO, LondonGoogle Scholar