Study of obstetric ICU admissions and maternal outcome
Dr. Soumini G FICOG, Dr. Harini
Analytical study of Intensive care unit (ICU) admissions during pregnancy is an accepted approach to identify severe risk factors for maternal morbidity and mortality. So analytical work up on obstetric ICU admissions in our department was done.
Objectives: To study the incidence of obstetric ICU admissions and to analyse the causes of obstetric ICU admissions, common indications, interventions and maternal outcome.
Materials and Methods: The study was an observational retrospective study on 100 random subjects admitted to Obstetric ICU of Government General Hospital/Rangaraya Medical College Kakinada during pregnancy or within six weeks postpartum from January 2015 to December 2016. Criterial factors were booking status, referral or inpatient shift to ICU, age, obstetric status, type of admission, primary diagnosis, associated medical and surgical condition, mode of delivery, details of supportive interventions and obstetric outcome.
Results: Total deliveries were 11284 in 12924 obstetric admissions in one year. The total admissions to the ICU were 483 obstetric patients (3. 73 %). Sample study was n=100. The mean maternal age was 24 ± 4. 2 years. Majority of the patients were Primipara (48%). The more common indications of ICU admission were hemorrhage (65%) eclampsia (18%). Transfusion of Blood and blood products was needed in 86. 8% of patients. 12% patients required mechanical ventilation. There were nine maternal deaths during the study period. The statistical analysis was done by using using SPSS 12. 0 fractional percentage and Chi-square test.
Conclusion: Obstetric haemorrhage with haemodynamic instability and eclamptic disorders are major causes of ICU admissions. Adequate antenatal care, screening, timely referral reduces ICU admissions and maternal mortality and morbidity.