ABSTRACT
Introduction: Due to the COVID-19 pandemic, critical care demands on our health service have come into focus. In our stand-alone maternity hospital, patients requiring more than single organ support must be transferred to a general adult hospital for critical care, however those requiring single organ support or increased levels of monitoring are cared for in our high dependency unit. This is best practice for our patients but must be staffed appropriately.We sought to quantify our burden of HDU admissions, and to ascertain our reasons for admission. Methods: We retrospectively examined our critical care admissions over a four-month period from July 2021 to October 2021. We separated our analysis into two groups- those admitted for obstetric reasons or those admitted for non-obstetric reasons (i.e. gynaecology patients). Results: Over the four months we examined there were 2642 births, including 832 caesarean sections. In that time, 33 women were admitted to our HDU for obstetric reasons, and six women were admitted for reasons related to a gynaecology procedure. Among our obstetric patients, preeclampsia was the most common reason for admission (48%), and postpartum haemorrhage was the second most common (39%). Sepsis was the most common reason for admission amongst our gynaecology patients. Discussion: The HSE guidelines for critically ill women in obstetrics in 2014 recognised that quantifying high dependency care needs for obstetric patients is challenging, as most are managed within their local maternity HDUs and are not included in national data [1]. The overriding principle in the care of sick postpartum women is to keep the woman and her baby together, if possible, to maximise bonding and ease psychological trauma [2]. Therefore, it is important that these patients are kept in their maternity hospital as far as is safe for them. We hope that by auditing our hospital’s critical care needs, we can ensure it is staffed appropriately, and more importantly that our staff receive the appropriate training in the management of the most common critical care issues.