Study of obstetric patients admitted to Intensive Care Unit (ICU) at Kathmandu Medical College Teaching Hospital

Saha, Rachana; Shakya, Archana

doi:10.3126/jkmc.v2i4.11777

Cited by 10 publications

(23 citation statements)

References 12 publications

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“…[13][14][15][16] However the mean age was higher than the results found in a study conducted by Saha R et al, which reported 24.5±4.8 years. [17] In our study number of booked cases (94%) was comparable to the study conducted by Gupta S et al showing 79.16% booked cases. [18] Only 6% of the cases were unbooked.…”

Section: Discussion:-supporting

confidence: 78%

Etio-Pathophysiological Profile and Outcome of Critically Ill Obstetric Patients Admitted to Obstetric Intensive Care Unit at a Tertiary Care Obstetric Hospital in Kashmir Valley: A Retrospective Cohort Analysis.

Rizvi¹,

Nabi²,

Din³

et al. 2017

IJAR

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Objective: To evaluate the reasons for admission and outcomes of obstetric patients admitted to the Intensive Care Unit at the tertiary care obstetric hospital of GMC Srinagar over a period of one year. Study design: Retrospective cohort analysis. Setting and Methods: Data of obstetric patients admitted to the Obstetric ICU of Lalla Ded hospital, a tertiary care obstetric hospital of GMC Srinagar, between January 2016 and January 2017 was retrospectively reviewed. Patient demographics, reason for ICU admission, need for ventilatory support and outcome were assessed. Results: Over the study period, 33,594 patients were admitted to the hospital, of which 31985 were obstetric and 1609 were gynaecology cases. 303 obstetrical patients out of 31985 patients (0.9%) needed ICU admission. Out of these ICU admissions, 131 patients (43%) were referred from other health centers, 101 (33%) required ventilator support. Nearly half (43.56%) were admitted due to severe obstetric hemorrhage, while 37.95% had pregnancy related hypertension with its complications followed by pregnancy with underlying cardiac disease including Peripartum cardiomyopathy and rheumatic heart diseases and sepsis. Overall mortality within the unit was 19 (6.27%) during the study period. Conclusion: Obstetric haemorrhage and complications of pregnancy related hypertension are the leading causes of ICU admission. Early detection with referral to tertiary care centre and involvement of multidisciplinary team with dedicated obstetric intensive care unit is the key to decrease morbidity and improve materno-fetal outcome in high risk pregnancies and in critically ill obstetric patient population.

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Section: Discussion:-supporting

confidence: 78%

Etio-Pathophysiological Profile and Outcome of Critically Ill Obstetric Patients Admitted to Obstetric Intensive Care Unit at a Tertiary Care Obstetric Hospital in Kashmir Valley: A Retrospective Cohort Analysis.

Rizvi¹,

Nabi²,

Din³

et al. 2017

IJAR

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“…This gives the incidence of 1.14% of all deliveries during the study period, which was low compared to a study done in one of the largest maternity hospital of Nepal which showed an ICU admission rate of 2.3% of all deliveries 12 . The major indications for ICU admission were hypertensive disorder and obstetric haemorrhage 13 . Three mortalities were noted during the study period among the admitted patients.…”

Section: Resultsmentioning

confidence: 99%

Incidence and predictors of severe obstetric morbidity in a teaching hospital

Bajagain

Saha

2017

J. Kathmandu Med. Coll.

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Background: Evaluation of severe obstetric morbidity is an important aspect of optimum maternal health. Towards this, the Waterstone and Mantel criteria have been used to know the incidence, predictors and causes of severe obstetric morbidity. Objectives: The study aimed to estimate incidence, predictors and causes of obstetric morbidity at Kathmandu Medical College and Teaching Hospital. Methods: A hospital-based prospective study was carried out from 1 st September 2014 to 31 st August 2015. All cases of severe obstetric morbidity according to the Mantel and Waterstone criteria were identifi ed. The socio-demographic and healthcare characteristics of extremely severe cases were compared with controls which included women who were admitted before and after the indexed cases. Results: There were 2270 deliveries during the study period, out of which 74 cases of severe obstetric morbidities were identifi ed i.e. an incidence of 32.5 per 1000 deliveries. During the study period, there were three maternal deaths attributed to conditions studied. Disease-specifi c morbidities per 1000 deliveries were 18.9 for haemorrhage, 9.2 for severe pre-eclampsia, 0.88 for eclampsia, 0.44 for haemolysis elevated liver enzyme and low platelet count and 3.08 for sepsis. A total of 26 patients were admitted in Intensive care unit which was 1.145 per 100 of total deliveries. Conclusion: Severe obstetric morbidity and its relation to mortality may be more sensitive measures of pregnancy outcome than mortality alone. In this study, most events are related to obstetric haemorrhage and severe pre-eclampsia.

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“…Most of the studies reviewed focused on inclusion of specific or severe maternal morbidity. 5,[7][8][9][10][11] Maternal mortality is used internationally as measure of the quality of obstetric intervention, although is now rare in the developed world. 7 Severe maternal morbidity have been used as a alternative measure.…”

Section: Discussionmentioning

confidence: 99%

“…7 Severe maternal morbidity have been used as a alternative measure. 7,11 Severe obstetric morbidity was defined clinically to be severe preeclampsia,severe obstetric hemorrhage and sepsis. [7][8] Overall incidence is 1.2% of all deliveries.…”

Section: Discussionmentioning

confidence: 99%

Obstetric Emergencies: Feto-maternal Outcome at a Teaching Hospital

Saha

Gautam

2014

Nepal j. obstet. gynaecol.

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Aims:This study was done to know the pattern of obstetric emergencies and its influence on maternal and fetal outcome.Methods: A descriptive study was carried out in the department of obstetrics and gynecology at Kathmandu Medical College Teaching Hospital from 1st June 2013 to 31 st May 2014. Cases were categorized as early pregnancy emergencies (ruptured ectopic pregnancy, complications of abortion), ante-partum emergencies and intra-partum emergencies (antepartum haemorrhage, preeclampsia, eclampsia, preterm prelabor rupture of membranes, rupture uterus), post-partum emergencies (postpartum haemorrhage, retained placenta, placenta accreta, uterine inversion), puerperal emergencies (postpartum sepsis), fetal emergencies (cord prolapse, shoulder dystocia). Outcome noted were type of emergency, obstetric intervention done, maternal and perinatal morbidity and mortality.Results: A total of 80 (4.45%) obstetric emergencies occurred among 1796 deliveries .The most common obstetric emergencies were obstetric hemorrhage (62.5%), severe preeclampsia (23.5%) and preterm prelabor rupture of membranes (10%). The obstetric interventions done were cesarean section (43.75%), exploratory laparotomy (33.75%) and blood transfusion (40%). Obstetric emergencies were responsible for 66.6% of total maternal death and 24.56% of total perinatal death. Conclusions:In spite of best efforts, some obstetric emergencies do occur. Obstetric hemorrhage and severe preeclampsia are the frequent obstetric emergencies. Cesarean section, exploratory laparotomy and blood transfusion were the commonly performed interventions. A better outcome can be achieved by national policy of promoting utilization of antenatal care, institutional deliveries, skilled birth attendance at delivery, liberal blood transfusion and regular training of doctors and nurses.

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Study of obstetric patients admitted to Intensive Care Unit (ICU) at Kathmandu Medical College Teaching Hospital

Abstract: Background: Pregnancy though physiological and uneventful can be associated with major maternal morbidity with

Cited by 10 publications

References 12 publications

Etio-Pathophysiological Profile and Outcome of Critically Ill Obstetric Patients Admitted to Obstetric Intensive Care Unit at a Tertiary Care Obstetric Hospital in Kashmir Valley: A Retrospective Cohort Analysis.

Etio-Pathophysiological Profile and Outcome of Critically Ill Obstetric Patients Admitted to Obstetric Intensive Care Unit at a Tertiary Care Obstetric Hospital in Kashmir Valley: A Retrospective Cohort Analysis.

Incidence and predictors of severe obstetric morbidity in a teaching hospital

Obstetric Emergencies: Feto-maternal Outcome at a Teaching Hospital

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