Pregnancy-related admissions to the intensive care unit.

We conducted a retrospective review of obstetric patients admitted to the intensive care unit at Al-Ain hospital during period January 1(st) 1997 to December 31(st) 2002, in order to identify the indications for admission and the outcome. A total of 60 patients were admitted during the six years. The frequency of admission was 2.6 per 1000 deliveries and obstetric patients represented 2.4% of all ICU admissions. Admission was planned in 11 patients (18%) and unplanned in 49 (82%). The mean (+/-SD) duration of stay in ICU was 1.6+/-1.5 days. The leading indications for admission were haemorrhage (28.4%) and preeclampsia/eclampsia (25%). Of the 60 admissions, 47 (78.4%) followed surgery. The mean APACHE II score was 5.0+/-3.0. Twenty-two patients (37%) had blood transfusions, and only two (3.3%) required ventilation. Of the 60 patients only 28 (46.7%) were deemed to have severe illness necessitating intensive care; the remaining 32 patients were suitable for high dependency care. The mean APACHE II score and duration of stay were significantly higher in these patients. There were two deaths, representing 3.3% of obstetric intensive care unit admissions. Our findings highlight the need for establishing a high dependency unit to avoid unnecessary admission to the intensive care unit and to ensure proper management.

The effect of maternal fasting on the fetal biophysical profile.

OBJECTIVES: To determine fetal biophysical profile changes in women observing Ramadan with uncomplicated singleton pregnancy. METHODS: In this cross-sectional observational study healthy women who were observing Ramadan at 30 weeks or more of gestation were recruited as well as a non-fasting control group matched for age, parity, and gestational age. Ultrasound examination included assessment of amniotic fluid volume, fetal bladder volume, fetal biophysical profile, and umbilical artery Doppler flow. RESULTS: A total of 162 pregnant women were observed. Mean umbilical artery pulsatility index, vertical amniotic pool depth, and fetal bladder volume were similar in the study and control groups. However, there was a significant difference in biophysical scores between the two groups. In the fasting group, 30 of 81 fetuses (37%) had a score of 6/8 compared with 11 of 81 fetuses (13.6%) in the control group (P=0.001). All fetuses in both groups with a biophysical score of 6/8 showed no breathing movements. CONCLUSIONS: Fetal breathing movements are reduced during maternal fasting.