Obstetrics critical care: a 2 years retrospective study in a medical college hospital of western India

ABSTRACT

Background: This study highlights the possibilities of new contribution to the management of high risk pregnancies and those pregnancies with unpredictable outcomes. The objective was to study the incidence and the clinical profile of antenatal and postpartum women requiring admission to the ICU, the interventions required in these women and final outcome.Methods: A retrospective cohort study of all obstetric critical care admissions during 2-year period from January 2016 to December 2017 was done at 1296 bedded tertiary care hospital. During the study total 349 obstetric patients were admitted to the ICU. The data were analysed by using percentage.Results: Primigravida (54.73%) were more as compared to multigravida (45.27%). Only 15.76% patients were in antepartum period while majority of patients (84.24%) were admitted during postpartum period. The main obstetric indications for ICU admission were pregnancy-induced hypertension (14.32%) followed by obstetric hemorrhage (9.16%) and community acquired pneumonia (7.44%). Other indications were valvular heart disease (5.44%), ANC with severe anemia (1.72%), monitoring (6.30%). In the present study maternal mortality among the women admitted to ICU was 18.05%. The leading cause of maternal death was obstetric hemorrhage (28.57%) followed by pregnancy induced hypertension (25.40%). An ICU intervention during the stay of the patients in terms of mechanical ventilation was used in 250 (71.63%) cases.Conclusions: A high quality multidisciplinary care is required in complicated pregnancies for safe motherhood. So, there is a need for dedicated ICU for obstetric patients.