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International Journal of Clinical Obstetrics and Gynaecology

International Journal of Clinical Obstetrics and Gynaecology

Print ISSN: 2522-6614, Online ISSN: 2522-6622

International Journal of Clinical Obstetrics and Gynaecology

2019, Vol. 3, Issue 6, Part C

Finding solutions to ending preventable maternal mortality; early transfer of critically ill obstetric patients to intensive care unit is associated with improved maternal mortality
Author(s): Armin Ahmed MD, Suhail Sarwar Siddiqui DM, Afzal Azim MD, Nabeel Muzaffar DM, Sulekha Saxena MD, Avinash Agarwal MD, Amita Pandey DM, Ayesha Ahmad MRCOG, Prabhaker Mishra and Monika Agarwal MD
Abstract:
Background: Maternal mortality remains high in developing countries. According to sustainable development goals set by United nations (UN) a global target of 70/100,000 live births is to achieved by 2030. It is required that all countries accelerate their maternal welfare programs and identify barriers and facilitators in ending preventable maternal mortality (EPMM).
Methodology: The study was conducted in 18 bedded adult Medical/Surgical ICU of tertiary care teaching hospital. Retrospective data collection was done for all obstetric patients (pregnant or within 6 weeks postpartum) admitted from 01-December 2017 to 30-November 2018. Triggering events for ICU admissions were identified {seizures, respiratory failure, shock, acute kidney injury, postop care of emergency caesarean section/exploratory laparotomy and postop care of elective caesarean section with complicated medical disease}. Triggering event to ICU admission interval was noted. Unpaired t test / Mann Whitney U test / Chi- square test was used to compare the distributions between survivor and non survivors while binary logistic regression analysis used to identify the predictors of the non-survivors. A p value of <0.05 was considered statistically significant.
Results: A total of 339 patients were admitted in ICU during the study period, out of which there were 60 obstetric patients. There were 42 (70%) survivors and 18 (30%) non- survivors. Non-survivors had higher SOFA and APACHE II at the time of admission [(6.4 + 3.2 vs 9.8+3.2; p = 0.000) and (15.6 +6.0 vs 19.7+5.6; p=0.016) respectively]. In multivariate analysis only triggering event to ICU admission interval [AOR=1.93, 95% CI=1.18-3.18, P=0.009] and need of dialysis [AOR=6.86, 95% CI=1.74-27.11, p=0.006] were found significant and independent risk factors of mortality.
Conclusion: Our study shows that early transfer of critically ill obstetric patient to intensive care unit improves survival. Among the various types of delay in maternal care, delayed ICU admission requires attention of planners and policy makers targeting maternal mortality.
Pages: 145-149 | 812 Views | 157 Downloads
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How to cite this article:
Armin Ahmed MD, Suhail Sarwar Siddiqui DM, Afzal Azim MD, Nabeel Muzaffar DM, Sulekha Saxena MD, Avinash Agarwal MD, Amita Pandey DM, Ayesha Ahmad MRCOG, Prabhaker Mishra, Monika Agarwal MD. Finding solutions to ending preventable maternal mortality; early transfer of critically ill obstetric patients to intensive care unit is associated with improved maternal mortality. Int J Clin Obstet Gynaecol 2019;3(6):145-149. DOI: 10.33545/gynae.2019.v3.i6c.404
International Journal of Clinical Obstetrics and Gynaecology