International Journal of Clinical Obstetrics and Gynaecology

Introduction:Maternal near-miss cases are defined as “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy”. Although pregnancy and puerperium are physiological processes, but serious complications can occur which can lead to maternal mortality and morbidity. Women in their puerperium are more at risk of ICU admission than pregnant women. Evaluation of obstetric admissions to intensive care unit (ICU) is one of the ways to approach surveillance of critically ill women in pregnancy in a tertiary care facility.

Materials and Methods:It is a prospective study of obstetric cases admitted to the intensive care unit over a period of 3 years from January 2022 to October 2024. All the pregnant and postpartum (up to 6 weeks post-delivery) patients admitted to the intensive care unit of SKIMS Soura were included in the study.

Statistical Analysis: Data was entered in Microsoft excel sheet and analyzed. Continuous variables were expressed as Mean±SD and categorical variables were summarized as frequencies and percentages.

Results and Observations: Among all obstetric cases 120 patients required ICU admission and the rate was 0.57%. Most common age group in our study was 26-30 years (35.8%). Most common period of admission to our ICU was during the third trimester (85%) followed by 1^st trimester (7.6%). Most common indication of ICU admission in our setting was heart disease present in 23.3% of patients followed by hypertensive disorders in 22.5%, obstetric haemorrhage in 21.6%, ruptured ectopic pregnancy in 7.5%, neurological disorders in 5.8%, kidney disease in 5%, anaesthesia related complications in 4.1%, connective tissue and haematological disorders in 2.5% in each, acute fatty liver of pregnancy and infections in 1.6% in each and molar pregnancy and thromboembolism in 0.8% of patients. Case fatality rate was 5.8% which was lower (6.8%) in other studies.

Conclusion: ICU admission complicates 0.57% of obstetric cases in our setup. This study provides detailed information regarding demographics, indications and outcome of critically ill patients so that maternal mortality and morbidity can be prevented by proper triaging of patients.