To analyze obstetric admissions to intensive care unit and to identify the risk factors responsible for intensive care admission
Author(s): Dr. Nishat Fatima and Dr. Somen Bhattacharjee
Abstract: Objective: To analyze obstetric admissions to intensive care unit and to identify the risk factors responsible for intensive care admission. Method: This is a retrospective study of all obstetric cases admitted to the intensive care unit over a period of 1 year. Data were collected from case records. The risk factors responsible for ICU admission were analyzed. Result: In the 12 month period from 1 January 2016 to 31 december 2016, 12828 women delivered in our hospital, with 67 maternal deaths, giving a maternal mortality ratio of 5.22/1000 deliveries. The total admissions in the obstetric ICU were 128 women (ICU utilization rate was 0.99 per 100 deliveries) with 61 (48%) survivors and 67 (52%) non-survivors. Majority of the patients belonged to 20-30 years age group (72.8%) 46.8% were primipara, 82 % were admitted in antepartum period. Most were in the gestational age between 37 and 40 weeks (38%) Obstetric hemorrhage found to be the most important antepartum risk factor (44%)after anaemia 58%.In our study ICU maternal mortality were 52%, majority of patients were referred from other peripheral centers and the majority were due to eclampsia and pre-eclampsia (58%) and postpartum hemorrhage (22%). Maternal mortality were 52%, majority of patients were referred from other peripheral centers and the majority were due to eclampsia and pre-eclampsia (58%) and postpartum hemorrhage(22%).Other disorders included jaundice 23%, puerperal sepsis 21%,ruptured uterus 14% and embolism 11%. The most important pre-existing medical complication was heart disease in 7% cases. The most common mode of delivery was cesarean section (39.7%) Obstetric hysterectomy was required in 5.1%, as a life saving procedure. The most common obstetric cause of ICU admission was obs haemorrhage (44%) of which 6 cases were complicated with disseminated intravascular coagulation. Majority required mechanical ventilation for<48 hours, (57.7%) Only 11 cases (8.5%) required for 4 days and more. Complications encountered While on Mechanical Ventilation are Multiorgan failure 6%, Pulmonary edema 4%, Renal failure 8%, Seizures 4%, Hepatic failure 6%, Deep-vein thrombosis 2%.
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