Obstetric Intensive Care Unit (ICU) Admission Evaluation: Experiences in a Tertiary Care Hospital
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 5
Abstract
Aims: To review pregnant patients up to 6 weeks postpartum who needs ICU admission. Methods: This cross sectional study was conducted in the Dept of OB-GYN of Chittagong Medical College Hospital, Bangladesh from 1st Jan’2014 to 30th June’2016. Pregnant patients up to 6 weeks postpartum admitted in dept of OB-GYN & subsequently shifted to ICU were included. Results: In our study period, out of total 47,941 obstetric patients, 124 transferred to ICU. The mean age 27.41 years [Range: 17 – 47 years]. Rural resident 69.35% (n=86). 54.84% (n=68) of middle class. Multi gravida / para 70.16 %( n=87). Antenatal 69.35%(n=86). 48.39% (n=60) received irregular antenatal care. Hypertensive disorder of pregnancy - most frequent obstetric indication for ICU admission which was 41.13%(n=51) [eclampsia: 26.61%(n=33); PE:13.71% (n=17); HEELP:0.81%(n=1)]. Obstetric hemorrhage stood second position which was 31.45% (n=39) [Rupture uterus 12.10% (n=15); APH due to placental cause 8.87% (n=11); PPH 6.45%(n=8); ectopic pregnancy 3.23% (n=4); molar pregnancy 0.81%(n=1)]. Obstructed labour & sepsis in 3rd & 4th position which included 9.68% (n=12) & 6.45% (n=8). Others 11.29% (n=14). However, 50% (n=62) transferred for both respiratory failure & hemodynamic instability, 41.94 % (n=52) for respiratory failure, 7.26% (n=9) for hemodynamic instability. Among 124 patients 41.94% (n=52) fully recovered. Majority 33.87%(n=42) stayed in ICU for 1 day [range:1-45 days]. Conclusion: Appropriate primary health care, efficient referral system & multidisciplinary approach including ICU is essential for management of these critical patients & to reduce maternal mortality & morbidity.
Authors and Affiliations
Tanjila Karim, Fahmida Shirin, Jannatul Ferdous
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