RESUMO
BACKGROUND: The objective of this study was to evaluate the course of pregnancy and delivery of obstetric patients admitted for intensive care, and determine the health status of their infants. METHODS: This was a retrospective register-based study. Four university hospitals in Finland participated. Obstetric patients admitted to the intensive care unit in any trimester of pregnancy, during delivery or up to 42â¯days post partum were identified from clinical information systems over a five-year study period. Parturient and infant data were collected from the Medical Birth Register. RESULTS: During the study period (2007-2011), 283 obstetric patients were identified from the clinical information system. The most common reason for admission was hypertensive complications (58%), followed by obstetric haemorrhage (25.1%). Advanced maternal age, nulliparity and multiple pregnancies were associated with obstetric intensive care unit admissions. Of patients admitted to intensive care, 68.9% delivered by unscheduled caesarean section. Nearly 60% of neonates were born preterm, 56.1% needed treatment in a neonatal intensive care unit or an observation unit and 4.6% died within one week. CONCLUSION: Advanced maternal age, nulliparity and multiple pregnancy were more common among intensive care unit-admitted women than in the general obstetric population. The main causes for admission were hypertensive complications and obstetric haemorrhage. Compared with the general obstetric population, neonates of intensive care unit-admitted mothers were eight times more likely to require treatment on a neonatal ward and their risk of neonatal death was also eight times greater.
Assuntos
Parto Obstétrico , Unidades de Terapia Intensiva , Adulto , Feminino , Nível de Saúde , Humanos , Hipertensão/complicações , Recém-Nascido , Masculino , Idade Materna , Hemorragia Pós-Parto/epidemiologia , Gravidez , Estudos RetrospectivosRESUMO
BACKGROUND AND AIMS: appendectomy wounds are still commonly closed with non-absorbable sutures. Stitch removal has financial costs and causes anxiety in children. Our aim was to compare interrupted non-absorbable (NA) and continuous intradermal absorbable (A) sutures in appendectomy wounds to evaluate whether absorbable suturing increases the risk of complications. MATERIAL AND METHODS: 198 children (age 4-18 years) including perforated cases were prospectively randomized into two groups (NA and A skin closure). The wounds and inflammatory markers were evaluated on the first two postoperative days. The appearance of the wound was evaluated one week postoperatively by a district nurse. Follow-up data were obtained from 166 patients (87 in NA group and 79 in A group). RESULTS: in NA group 86 % and in A group 81 % had appendicitis (8 % and 15.6 % perforated and 9.3 % and 25 % gangrenous cases in NA and A groups, respectively). The total wound infection rate was low, 1.8 % (2.3 % in NA Group and 1.3% in A Group). No differences in the inflammatory markers or the appearance of the wound were noted between the groups, but nine children in NA Group (10.3 %) had a partial wound dehiscence after stitch removal. CONCLUSION: appendectomy wounds in children can be closed with continuous, absorbable sutures, even in complicated cases.