ABSTRACT
Objectives@#This is the first study that provides an overview of the characteristics of a specialized Intensive Maternal Care Unit (IMU) that caters to obstetric-related conditions in the Philippines. This study aims to describe the different kinds of cases admitted into this facility, the different medical and surgical interventions employed, length of hospital stay, and maternal and fetal outcomes of these patients.@*Methods@#This is a cross-sectional descriptive study based on a chart review of medical records and admission charts of patients admitted to the Intensive Maternal Unit of a tertiary hospital in Manila from January 2017 to December 2019.@*Results@#There were a total of 17,185 obstetric admissions from 2017-2019. There were a total of 841 admissions (4%) into the Intensive Maternal Unit, with an average of 280 admissions per year. The average length of Intensive Maternal Unit stay was 10.46 days and the average length of hospital stay was 12.98 days. Maternal outcomes were the following: 56.89% were discharged undelivered while 38.92% delivered on their initial admission. The maternal mortality rate was 2.39% among those admitted to the IMU. Among those discharged undelivered, 43% were re-admitted, 6% were admitted twice, and 4% were admitted three times. The most common reason for admission was pregnancy-related hypertensive diseases (34%). Blood transfusion (2.4%), the use of ventilator support (0.6%), and the use of inotropic drugs (0.6%) were the major medical interventions. Cesarean section was the most common surgical intervention, seen in 54.49% of patients. Most neonates were admitted to the neonatal ICU (23.95%), at an average pediatric age of 33 weeks, with an average length of stay in the Neonatal ICU of 12.33 days.@*Conclusion@#Pregnant women are a special group of patients with different needs compared to the general patient population. Pregnancy-associated hypertensive disease is the most common cause of admission to the IMU and hospitals should be able to cater to these patients who will present in their institutions, as this may lead to poor maternal and neonatal outcomes. An Intensive Care Unit dedicated to complicated obstetric care in institutions is recommended to cater to high-risk pregnancies.
Subject(s)
Pregnancy , Intensive Care Units , Critical CareABSTRACT
@#<p>Sheehan's syndrome is a rare complication of post-partum hemorrhage that has decreased in incidence in the past decade due to better obstetrical practices, although still seen in developing countries. This is a case of a 31-year-old Gravida 1 Para 1 (1-0-0-0) with a 1-year history of enlarging maxillary sinus mass, where an incidental finding of an empty sella in an MRI with contrast was noted. The patient had amenorrhea of 15 years and received no medications for her undiagnosed Sheehan's syndrome incurred during her first and only pregnancy. The patient's cardiomyopathy and organizing hematoma may be rare complications of Sheehan's syndrome. Patients, laymen, health practitioners, and traditional birth attendants should be informed of these complications. Treatment should be individualized and administered after diagnosing a patient with Sheehan's syndrome to prevent complications such as adrenal insufficiency, hypothyroidism, infertility, and seen in this case, acute heart failure and possibly organizing hematoma.</p>
Subject(s)
Humans , Female , Cardiomyopathy, DilatedABSTRACT
BACKGROUND@#Cannabis, the source of Δ9-tetrahydrocannabinol (THC), the primary psychotropic compound, and cannabidiol (CBD), a nonpsychoactive chemical with potential therapeutic properties, has been widely used as a psychoactive drug, medicinal drug, or industrial hemp. Cannabinoids exert their effect in the brain mainly by interacting with two types of receptors: CB1 and CB2 receptors, which are currently being studied for its possible therapeutic effects for the symptomatic treatment of Parkinson’s Disease.@*METHODOLOGY@#Databases searched were PubMed via National Center for biotechnology Information, CINAHL, Medline, Academic Search, Biomedical Reference collection, via EBSCOhost, and Cochrane Library. Queries were sent to local institutions for unpublished studies compatible with the criteria for study eligibility. Participants’ characteristics, study design, intervention features, outcome variables, reported effects, and study quality were retrieved. Random effects model was used because heterogeneity was significant.@*RESULTS@#The analysis of the four clinical trials included in the study showed that Cannabis and its derivatives’ effects on the mean motor UPDRS showed statistically significant decrease.@*CONCLUSION@#Cannabis and its derivatives may have an effect in the short-term symptomatic treatment of Parkinson’s Disease, although controlled studies with larger samples must be done before any conclusions may be made.