Analysis of obstetric patients treated in general intensive care unit.

Abstract

Objective: Obstetric patients are admitted to the intensive care unit (ICU) for reasons related to pregnancy, fetal health and aggravated previous illnesses. This study aims to analyse the reasons for and the frequency of the admissions of obstetric patients to the ICU, their specific treatment and the outcome. Method: After obtaining the approval of the Ethics Committee of Uludag University Medical Faculty, we analysed retrospectively 58 obstetric admissions to the ICU between 1 January 1994 and 31 December 2005. We recorded demographic and obstetric data, admission diagnosis, specific intensive care treatment, duration of stay and outcome. Acute Physiology and Chronic Health Evaluation (APACHE) II scores, Simplified Acute Physiology Scores (SAPS) II and Sequential Organ Failure Assessment (SOFA) scores were collected. Results: The mean age for all the obstetric ICU admissions was 29.4(plus or minus)6.5 years and the mean gestational age was 32.8(plus or minus)6.6 weeks. The most common causes of ICU admissions were preeclampsialeclampsia (29.3%), puerperal sepsis (18.9%) and obstetric haemorrhage (17.2%). Only 27.6% of these obstetric patients had received prenatal care. Mechanical ventilation was provided in 89.7% of the patients and blood or blood component transfusions were required in 86.2% of the cases. There were significant differences in the APACHE II and SAPS II scores between survivors and non-survivors (p<0.05). The mean duration of ICU stay was 12.9(plus or minus)11.7 days and the overall maternal mortality rate was 29.3%. Conclusion: Pregnancy-induced hypertension, puerperal sepsis and obstetric haemorrhage were the main reasons for the admission to the ICU.