Profile of Obstetric Patients in Intensive Care Unit: A Retrospective Study from a Tertiary Care Center in North India

Abstract

A bstract Background Critically ill obstetric patients constitute a small number of intensive care unit (ICU) admissions. Physiological changes in pregnancy along with certain pregnancy-specific diseases may cause a rapid worsening of the health status of the patient necessitating ICU care. The present study aims to study the clinical profile of the obstetric patients requiring ICU care. Materials and methods It was a retrospective analysis of pregnant/postpartum (up to 6 weeks) admissions over a period of 18 months. Results Over these 18 months, 127 women required ICU admission. The most common reasons for ICU admission were obstetric hemorrhage (37.79%) and (pre)eclampsia (28.35%). Ten patients presented with antepartum hemorrhage (placenta previa, placenta accreta, placenta increta). The rest of the patients ( n = 38) had atonic postpartum hemorrhage with five having severe anemia. Among the nonobstetric causes ( n = 26/127), ICU admission was the most common among those with preexisting heart diseases ( n = 10; 7.87%). Forty-nine patients were ventilated mechanically (38.58%), with eclampsia being the most common primary diagnosis ( n = 23). We observed 10 maternal deaths (7.87%) with septicemia being the most important cause of death. Conclusions Maternal and child health has become an important measure of human and social development. Early diagnosis and prompt treatment of high-risk obstetric patients in a dedicated obstetric ICU in tertiary hospitals can prevent severe maternal morbidity and improve maternal care. How to cite this article Gupta H, Gandotra N, Mahajan R. Profile of Obstetric Patients in Intensive Care Unit: A Retrospective Study from a Tertiary Care Center in North India. Indian J Crit Care Med 2021;25(4):388–391.

Study on clinical profile, scoring systems and outcomes of obstetric patients in our intensive care unit

“…The mean age group of the patients in our study was 27±5 years, comparable to other studies by Bahadur et al, Gupta et al 7,8 Majority of patients admitted to ICU were multigravida (55.2%) similar to Gupta et al and Verma et al 8,9 82.8% of patients needed ICU care in their antenatal period as compared to Joseph et al, Bhadade et al 10,11 As our hospital is a tertiary care center, 60.4% (unbooked) cases admitted to ICU were referred from other hospitals for further management as they were not well equipped to manage obstetric emergencies which is comparable to the study by Ashraf et al 12 Out of the maternal admissions to the ICU, 70.9% had predominant obstetric causes and 29.1% had non obstetric causes. Peripartum cardiomyopathy, idiopathic thrombocytopenic purpura, congenital heart disease, seizures unrelated to eclampsia constituted the majority of the non-obstetric etiologies (Table 1).…”

“…Maternal admissions into the ICU constituted about 3.3% of overall ICU admissions and 1.7% of total deliveries in the 30 months of study period compared to 1.29% of all deliveries in the study by Bahadur et al, 0.8% of all deliveries in the study by Verma et al and 0.14% by Gupta et al [6][7][8][9] The higher rate of ICU admissions of obstetric patients in our study could be due to the presence of renowned obstetricians in our center and the significant number of patients coming for obstetric care. Since our hospital is a tertiary care referral center, complicated obstetric cases are referred to us for multidisciplinary care.…”

Características de pacientes obstétricas admitidas em Unidade de Terapia Intensiva

“…• Fatores ambientais: a exposição a agentes tóxicos, como a poluição, o aumento da temperatura global, entre outros, também podem aumentar o risco de complicações durante a gestação e o parto (KRAWCZYK et al, 2021;FARR et al, 2017;GUPTA;GANDOTRA;MAHAJAN, 2021;SAINTRAIN et al, 2016).…”

Diagnostic accuracy of serological rk-39 test for visceral Leishmaniasis: Systematic review and meta-analysis

“…The diagnosis is based on the combination of clinical signs and symptoms with laboratory confirmation [ 12 ]. The laboratory analysis is performed by demonstrating Leishmania parasites in microscopic preparations taken from the spleen, bone marrow, or lymph node aspirates, which is considered to be the gold standard test [ 13 ]. However, the low sensitivity combined with the invasive and risky sample collection procedures deterred the implementation of microscopy in remote endemic areas [ 14 ].…”