To analyze obstetric admissions to intensive care unit and to identify the risk factors responsible for intensive care admission (original) (raw)

Abstract

To analyze obstetric admissions to intensive care unit and to identify the risk factors responsible for intensive care admission. Method: This is a retrospective study of all obstetric cases admitted to the intensive care unit over a period of 1 year. Data were collected from case records. The risk factors responsible for ICU admission were analyzed. Result: In the 12 month period from 1 January 2016 to 31 december 2016, 12828 women delivered in our hospital, with 67 maternal deaths, giving a maternal mortality ratio of 5.22/1000 deliveries. The total admissions in the obstetric ICU were 128 women (ICU utilization rate was 0.99 per 100 deliveries) with 61 (48%) survivors and 67 (52%) non-survivors. Majority of the patients belonged to 20-30 years age group (72.8%) 46.8% were primipara, 82 % were admitted in antepartum period. Most were in the gestational age between 37 and 40 weeks (38%) Obstetric hemorrhage found to be the most important antepartum risk factor (44%)after anaemia 58%.In our study ICU maternal mortality were 52%, majority of patients were referred from other peripheral centers and the majority were due to eclampsia and pre-eclampsia (58%) and postpartum hemorrhage (22%). Maternal mortality were 52%, majority of patients were referred from other peripheral centers and the majority were due to eclampsia and pre-eclampsia (58%) and postpartum hemorrhage(22%).Other disorders included jaundice 23%, puerperal sepsis 21%,ruptured uterus 14% and embolism 11%. The most important pre-existing medical complication was heart disease in 7% cases. The most common mode of delivery was cesarean section (39.7%) Obstetric hysterectomy was required in 5.1%, as a life saving procedure. The most common obstetric cause of ICU admission was obs haemorrhage (44%) of which 6 cases were complicated with disseminated intravascular coagulation. Majority required mechanical ventilation for<48 hours, (57.7%) Only 11 cases (8.5%) required for 4 days and more. Complications encountered While on Mechanical Ventilation are Multiorgan failure 6%, Pulmonary edema 4%, Renal failure 8%, Seizures 4%, Hepatic failure 6%, Deep-vein thrombosis 2%.

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