analysis of critically ill obstetric patients admitted to intensive care unit of a tertiary care centre

ABSTRACT

To review the demographic characteristics, indications for admission and interventions done in the intensive care unit for critically ill cases as well as the outcome of these patients. Prospective, observational and descriptive study. Intensive care unit of Benazir Bhutto Hospital, Rawalpindi. Duration was from January 2009 - December 2009. All the obstetric patients admitted to the intensive care unit from January 2009 - December 2009 were included. Data was collected on a specially designed form after taking informed valid consent from family members of critically ill patients. The relevant data regarding demographic features, indications for admission, intervention done and pregnancy outcome was recorded. Statistical analysis was done using SPSS software. Thirty seven obstetric patients [mean age, 32 years; mean gestational age, 32 weeks] were analysed. The most common cause of obstetric admissions was haemorrhage [n=14, 38%] and postpartum haemorrhage [n=7,19%] being the commonest among this group. After haemorrhage comes pregnancy associated hypertensive disorders [n=6, 16%] and sepsis [n=6,16%]. The commonest non-obstetric reason for admission was cardiac disease [n=5,13.5%]. Ventilatory support was required in 30% [n=11]. In 48.5% of the patients monitoring was done using central venous pressure line. lonotropic support was given to 38% of the patients. 88% patients received more than 2 blood transfusions. Haemorrhage especially the postpartum haemorrhage was the most common cause of admissions to the intensive care unit followed by preeclampsia/eclamsia and sepsis. Most of the maternal deaths are preventable but need appropriate antenatal care, availability and access to comprehensive obstetric care along with overall improvement in socio-economic conditions and literacy rate of the society