Obstetric intensive care admissions: a four-year review in a Tertiary Care Centre

Abstract

Objective: To review of obstetric patients admitted to intensive care unit (ICU) in a tertiary care center and to assess the prevalence, causes and outcome of critically ill obstetric patients in ICU. Methods: In this retrospective study, obstetric ICU admissions in a University hospital over four-year period from January 20005 to April 2009 were analyzed. Results: The incidence of obstetric admissions to the ICU represented 1.6% of deliveries. All of the patients were admitted to the ICU postpartum. Pregnancy induced hypertension (64%) and obstetric hemorrhage (30%) were the two most common reasons for the ICU admission. The most common interventions were magnesium sulphate infusion (53.9%), mechanical ventilation (48%), and blood transfusion (52.9%). Maternal mortality rate was 8.8% with 44% of hemodynamic instability and multiple organ failure and with 44% of acute respiratory distress syndrome as the main causes of death. Conclusion: The most common cause of ICU admission were pregnancy induced hypertension and obstetric hemorrhage. Improved management strategies to these problems and increasing antenatal care may significantly decrease the maternal and fetal mortality rate in obstetric patients admitted to the ICU.