Prognostic factors in obstetric patients admitted to an Indian intensive care unit*

Abstract

Multiple organ failure is common in obstetric patients; mortality rate increases with increasing organ failure. APACHE II scores overpredict mortality rate. Standardized mortality ratio is lower in obstetric disorders than in medical disorders. Lack of prenatal care and delay in intensive care unit referral adversely affect outcome and are easily preventable.

Hepatitis E and Acute Liver Failure in Pregnancy

“…Among the major causes of liver failure including viral hepatitis, acute fatty liver of pregnancy and HELLP syndrome, only viral hepatitis was associated with a poor maternal outcome. 41 …”

Utility of Acute Physiology, Age, and Chronic Health Evaluation (APACHE III) score in maternal admissions to the intensive care unit

“…[4][5][6][7][8][9][10] Although some researchers found that APACHE II accurately predicted maternal death, 4,10 other researchers found that APACHE II overestimated maternal mortality rates 5 or, conversely, that it underestimated maternal mortality rates because of obstetric problems. 7 These differences may be due to higher mortality rates in some populations 7,9 or to overutilization of ICUs in less acutely ill populations 10 The only study in the United States to address this question used another scoring system, SAPS II. That study found that this system overestimated maternal mortality rates in all patients and specifically in patients who were admitted with obstetric indications but accurately predicted death in patients who were admitted for medical reasons.…”

“…[1][2][3] Some studies have described the usefulness of ICU scoring systems in pregnant women, [4][5][6][7][8][9][10][11] but only 1 study has been based in the United States. 11 Gilbert et al 11 recently summarized the use of the Simplified Acute Physiologic Score (SAPS II) in 233 antepartum and postpartum patients who were admitted to a medical ICU in New Jersey from 1991 to 1998.…”

The Utility of the Sequential Organ Failure Assessment Score in Predicting Mortality in Critically Ill Obstetric Patients Admitted to a High Dependency Unit in Uganda

“…Some of these are referred to as maternal near miss in case they narrowly survive death from such severe complications [5,6]. Both early recognition, detection and referral of potentially life threatening severe obstetric complications, and prompt access to safe, affordable basic and emergency obstetric care, are essential to reduce maternal morbidity and mortality [3][4][5][6].…”

“…On this continuum are patients with severe obstetric complications, severe maternal morbidity (SMM), who develop organ or system dysfunction [3,4]. Some of these are referred to as maternal near miss in case they narrowly survive death from such severe complications [5,6].…”