A retrospective analysis of obstetric patient′s outcome in intensive care unit of a tertiary care center

Abstract

Background and Aims:Admission to an intensive care unit (ICU) is considered as an objective marker of severe maternal morbidity. The aim was to assess the incidence and possible risk factors of obstetric patient admissions in the multidisciplinary ICU of a tertiary care center with emphasis on standardized mortality ratio (SMR).Material and Methods:A retrospective five year ICU record analysis was done for all pregnant women, who were admitted to multidisciplinary ICU of a tertiary care hospital during June 2007-12.Results:During this 5-year period, 21,943 deliveries took place and 164 women required ICU admission. Out of these, the data of 151 patients were analyzed. Maternal mortality rate was 31.1% (47 deaths) for patients admitted to ICU. The simplified acute physiologic score (SAPS) II was 62 (55-68) in nonsurvivor versus 34.00 (28-46) in survivor group (P value < 0.001). The receiver operated characteristic curve was plotted using SAPS II scores and the area under the curve was 0.93 with 95% confidence interval (0.89-0.96). The calculated SMR was 0.97.Conclusions:Women admitted to ICU with diagnosis of puerperal sepsis and intrauterine death (IUD) with coexisting sepsis had higher mortality as compared to women with hypertensive disease of pregnancy and hemorrhage. The calculated SMR was less than one which is a predictor of good ICU care.

Critically ill obstetric patients in a general critical care unit: A 5 years′ retrospective study in a public teaching hospital of Eastern India

“…The mean age and the age distribution of the critically ill obstetric patients in the present study correlate with other contemporary Indian studies,[172021222324] but studies from abroad report a higher maternal age. [11131415] Although advanced maternal age has not been shown to be uniformly associated with CCU admissions and a median age of 30 years is consistent with birth age patterns in developed countries,[27] the noteworthy point in Indian studies is the need of critical care in the patients well under thirty.…”

“…[18192324] The median duration (in days) of ventilation of 2 (IQR 1-7) in our study closely correlates most Indian studies. [172122] The high central venous catherization rate (84.88%) in our study, although similar to an Indian study headed by Bhadade et al (82.8%),[18] is much higher than that in studies from abroad. [11121315] This high rate was mainly for taking advantage of multiple venous accesses for unstable patients.…”

Clinical Characteristics and Mortality of Obstetric Patients Admitted to a Tertiary Intensive Care Unit in the Brazilian Northeast

“…In a systematic review of the literature during 1990-2008, the hypertensive syndrome was found to be the most prevalent in a specific obstetric cause for hospitalization (5,14) Hypertensive gestational syndromes including chronic hypertension and the entire spectrum of preeclampsia, complicated about 7% of the pregnancies. Moreover, deaths related to this clinical condition have been constantly reported, often ranging from 1 to 24% (15). In the current study, mortality rate (44.4%) was higher than that of expected in the available literature.…”

“…There are some predisposing factors for sepsis in pregnancy such as CS, lack of prenatal care, abortion induction, premature rupture of the placental membrane, and conditions inherent to the obstetric population (15,16).…”

An appraisal of mortality in Intensive Care Unit of a Level III military hospital of Bangladesh

“…Admission to an ICU is measured as an indicator of severe morbidity. [ 10 ] Thereafter, the current study was designed to review the data retrieved from the archive on the deaths in ICU. It was carried out by analyzing the fatal case documents of deaths occurred during 2-year duration in a 9-bedded ICU to investigate mainly the mortality rate among the critically ill patients.…”