Clinical Characteristics and Outcome of Obstetric Patients Who Required Mechanical Ventilation in a Tertiary Care Hospital in North Kerala.

ABSTRACT

Objectives: To describe the clinical characteristics of obstetric patients requiring mechanical ventilation in a tertiary referral hospital and their maternal and perinatal outcome in order to identify their risk factors and clinical outcome and determine adverse prognostic factors in these patients. Study design: A prospective study was conducted in the Dept. of Obstetrics and Gynecology, Government Medical College, Kozhikode on all pregnant women up to 6 weeks postpartum from January 1, 2011 to December 31, 2013 and who subsequently required mechanical ventilation. Data was recorded in a predesigned proforma and was analyzed and frequency, and percentages were calculated. Results: In the 3-year period, 75 obstetric patients required mechanical ventilation. Majority were between 20-35 years (88%) and were primipara (53.3%). Eighty percent were admitted in the antepartum period and most were in the gestational age of 30-36 weeks (41.3%). Hypertensive disorder is an important antepartum complication (29.3%). Postpartum hemorrhage was the important cause (45.3%) of ICU admission. About 49.3% required mechanical ventilation for <24 hours and multiorgan failure was the important complication encountered (13.3%). Conclusions: Providing optimal prenatal care and improving the management of hemorrhagic complications and hypertensive disease can improve the morbidity and mortality of critically ill obstetric patients requiring mechanical ventilation.